Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jan 1;277(1):38-42.
doi: 10.1097/SLA.0000000000005537. Epub 2022 Jul 15.

No Reduction in Parastomal Hernia Rate 3 Years After Stoma Construction With Prophylactic Mesh: Three-year Follow-up Results From STOMAMESH-A Multicenter Double-blind Randomized Controlled Trial

Christian Ringblom  1   2 , Christoffer Odensten  1   2 , Karin Strigård  1 , Ulf Gunnarsson  1 , Pia Näsvall  1   2
Affiliations
Randomized Controlled Trial

No Reduction in Parastomal Hernia Rate 3 Years After Stoma Construction With Prophylactic Mesh: Three-year Follow-up Results From STOMAMESH-A Multicenter Double-blind Randomized Controlled Trial

Christian Ringblom et al. Ann Surg. .

Abstract

Objective: The primary objective was to compare rates of parastomal hernia (PSH) 3 years after stoma construction with prophylactic mesh or no mesh. A secondary objective was to compare complications requiring reintervention within 3 years.

Background: Recent studies have shown that a prophylactic mesh does not reduce the rate of PSH contrary to older studies. Long-term data on efficacy and safety is however scarce.

Methods: A randomized controlled double-blind multicenter trial. Patients planned for permanent end colostomy were randomized to either prophylactic mesh in the retromuscular position around the stoma site or no mesh. They were evaluated for PSH clinically and with computed tomography (CT) 3 years after stoma construction. Medical records of all patients included were also reviewed at 3 years to detect any abdominal or abdominal wall surgery during that period.

Results: A total of 232 patients were randomized. At 3 years, 154 patients were available for clinical evaluation and 137 underwent a CT scan. No significant difference in PSH rates was seen between the treatment allocation arms (clinical: P =0.829 and CT: P =0.761, respectively), nor was there a significant difference in the number of reinterventions, but 2 patients had their mesh removed at emergency surgery.

Conclusions: Prophylactic mesh does not reduce the rate of PSH and cannot be recommended for routine use.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart.
See this image and copyright information in PMC

References

    1. Carne PWG, Robertson GM, Frizelle FA. Parastomal hernia. Br J Surg. 2003;90:784–793. - PubMed
    1. Pilgrim CHC, McIntyre R, Bailey M. Prospective audit of parastomal hernia: prevalence and associated comorbidities. Dis Colon Rectum. 2010;53:71–76. - PubMed
    1. van Dijk SM, Timmermans L, Deerenberg EB, et al. . Parastomal hernia: impact on quality of life? World J Surg. 2015;39:2595–2601. - PubMed
    1. Näsvall P, Dahlstrand U, Löwenmark T, et al. . Quality of life in patients with a permanent stoma after rectal cancer surgery. Qual Life Res. 2017;26:55–64. - PMC - PubMed
    1. Hansson BME, Slater NJ, van der Velden AS, et al. . Surgical techniques for parastomal hernia repair: a systematic review of the literature. Ann Surg. 2012;255:685–695. - PubMed

Publication types