Is absorbable mesh useful in preventing parastomal hernia after emergency surgery? The PARTHENOPE study

Purpose Colostomy is a frequent event in oncological or inflammatory bowel diseases. Its related morbidity includes retraction, infection and parastomal hernia (PH), which is a quite common late complication. Several surgical options are available for PH repair, the majority including mesh. However,...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2022-04, Vol.26 (2), p.507-516
Main Authors: Pizza, F., D’Antonio, D., Lucido, F. S., Del Rio, P., Dell’Isola, C., Brusciano, L., Tolone, S., Docimo, L., Gambardella, C.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Chronic obstructive pulmonary disease
Colon
Colostomy - adverse effects
Colostomy - methods
Computed tomography
Diabetes mellitus
Hernia
Hernias
Herniorrhaphy
Humans
Incisional Hernia - prevention & control
Inflammatory bowel diseases
Medicine
Medicine & Public Health
Morbidity
NCT
NCT04436887
Original Article
Ostomy
Patients
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Prospective Studies
Surgery
Surgical Mesh
Surgical Stomas
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Summary:Purpose Colostomy is a frequent event in oncological or inflammatory bowel diseases. Its related morbidity includes retraction, infection and parastomal hernia (PH), which is a quite common late complication. Several surgical options are available for PH repair, the majority including mesh. However, results are often disappointing with relevant recurrence rates, up to 33%. The study aim was to assess the feasibility and effectiveness of prophylactic biosynthetic mesh (BIO-A ® , polyglycolide-trimethylene carbonate copolymer) placed during colostomy fashioning, in reducing PH. A prospective randomized controlled double-blind trial was conducted from January 2014 to December 2019 to compare conventional end-colostomy with end-colostomy reinforced with BIO-A mesh in ante-rectus position in patients undergoing colon diversion in emergency surgery. Methods Patients were clinically followed up at 3, 6, and 12 months and received a CT scan at 6 and 12 months. The postoperative morbidity and wound events were also evaluated. Results 55 patients receiving conventional colostomy considered as Control Group and 55 patients receiving BIO-A mesh supported colostomy (Mesh Group) were included in the study. At 12 months, the incidence of PH was 9 (12.7%) and 24 (43.6%) in the Mesh Group and Control Group, respectively ( p   70 years ( p  = 0.041), diabetes ( p   7 cm ( p  
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-022-02579-w