Prophylactic Effect of Simultaneous Placement of Mesh on Incidence of Parastomal Hernia After Mile’s Surgical Resection of Colorectal Cancer: A Prospective Study

Background: To assess the prophylactic effect of simultaneous placement of mesh and incidence of parastomal hernia (PSH) after abdominoperineal resection of rectal cancer. Methods: This study included real world data of 56 surgically resected colorectal cancer (CRC) patients who were consecutively assigned to 2 groups: control (no mesh, n=32) and experimental (received mesh, n=24). An artificial patch was placed under the tunica vaginalis of rectus abdominis for patients in experimental group whereas the control group received routine sigmoidostomy. The median follow-up time was >20 months. Difference in hazards function was analyzed by cox regression analysis and results were expressed as hazard ratio (HR) and 95% confidence interval (CI). A P-value < 0.05 was considered as significant. Results: Post-operative incidence rate of PSH was lower in experimental (41.7 %) than in control group (71.9 %; P=0.045). PSH postoperative time in experimental group was significantly delayed than control group (48 months vs 10 months; P<0.001). The risk of progression from H1 to H2 was less in experimental group than control group (49.28% vs. 60.86%; P=0.14). Conclusions: Prophylactic mesh placement significantly prolonged post-operative time to recurrence and incidence rate of PSH. The incidence of recurrence of H2 (severe PSH) requiring secondary surgical repair was reduced.