Background and Aims: Stomal site incisional hernia is a complication following ileostomy
closure, with rates about 40%. Because there were no previous studies undergone to
find a definite solution for it. Different preventive methods was studied to decrease the
incidence of post-ileostomy closure incisional hernia. One of these methods was the usage
of prophylactic mesh reinforcement mode of absorbable poliglecaprone monofilament
fiber and non-absorbable polypropylene monofilament fiber) during ileostomy closure and
study its role in prevention of stomal site incisional hernia without increasing the incidence
of wound complications.
Aim of the work: Evaluating the importance of prophylactic mesh reinforcement during
closure of ileostomy to prevent stomal site incisional hernia.
Methods: This was a retrospective study, included 40 Egyptian patients presenting for
ileostomy closure. Half of them without mesh and the other half applied mesh at ileostomy
site during closure. Patients of the two groups underwent ileostomy closure between
February 2018 and March 2020 and then they had been assessed in the following two
years for the occurrence of postoperative incisional hernias.
Results: Regarding the incidence of incisional hernia, 10 out of 40 patients (25%) in the
current study developed incisional hernias. In group B (without mesh reinforcement) 8
patients (40.0%) developed incisional hernias, while in group A (with mesh reinforcement)
2 patients (10.0%) developed incisional hernias. Although there was trend for developing
incisional hernia in patients without mesh reinforcement and the study shows significant
result of incisional hernia reduction with mesh reinforcement during the first six months
after closure (p=0.035), prophylactic mesh repair significantly reduce that incidence in the
total follow-up period of the two years (p=0.028).
Conclusion: The study shows significant decrease of incisional hernia with mesh
reinforcement during the first six months after closure. However, in the total follow-up
period of the two years prophylactic mesh repair significantly reduce post-ileostomy
closure incidence of incisional hernia, without significantly increasing the incidence of
wound infection. |
