Prophylactic intraperitoneal mesh placement to prevent incisional hernia after stoma reversal: a feasibility study

BACKGROUND: Incisional hernias in old stoma wounds occur in one-third of stoma patients and pose a significant clinical problem. Parastomal prevented by prophylactic mesh placement; however, no trial results are for incisional hernia prevention after stoma reversal. In this we explore the safety of placing an intraperitoneal mesh to prevent herniation after temporary stoma reversal. METHODS: Ten patients who low anterior resection with a deviating double-loop stoma for rectal received an intraperitoneal parastomal mesh at the time of stoma stoma reversal, laparoscopy was performed and adhesions were scored. reversal, the mesh defect was closed. Mesh and stoma complications were monitored. Incisional herniation was assessed at the 2-year follow-up reversal using ultrasonography. RESULTS: No infections occurred after placement. After a median of 6 months, stomas were reversed. Laparoscopy performed in seven patients; all patients had adhesions (median of 25 % surface). In three patients, the bowel was involved; one required a for bowel mobilization during stoma reversal. No adhesion-related noted at any time. Except for one superficial wound infection after reversal, no infectious complications were observed. After a median 26 months, no incisional herniations were demonstrated. CONCLUSIONS: mesh placement in temporary stoma formations seems safe and feasible and incisional herniation 2 years after stoma reversal.