Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study

Introduction: There are many methods to prevent hernia following stoma closure; however, there is a lack of evidence of the efficacy of prophylactic sublay synthetic mesh placement. This study aimed to investigate the safety of sublay mesh placement during stoma closure. Methods: Patients with rect...

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Main Authors: Yana Belenkaya, Sergey Gordeev, Nikolay Matveyev, Zaman Mamedli
Format: Article
Language:English
Published: Galenos Publishing House 2024-12-01
Series:Turkish Journal of Colorectal Disease
Subjects:
Online Access:https://www.turkishjcrd.com/articles/prophylactic-sublay-mesh-placement-during-stoma-closure-to-prevent-incisional-hernias-a-pilot-study/doi/tjcd.galenos.2024.2023-10-2
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author Yana Belenkaya
Sergey Gordeev
Nikolay Matveyev
Zaman Mamedli
author_facet Yana Belenkaya
Sergey Gordeev
Nikolay Matveyev
Zaman Mamedli
author_sort Yana Belenkaya
collection DOAJ
description Introduction: There are many methods to prevent hernia following stoma closure; however, there is a lack of evidence of the efficacy of prophylactic sublay synthetic mesh placement. This study aimed to investigate the safety of sublay mesh placement during stoma closure. Methods: Patients with rectal cancer who underwent stoma closure with prophylactic sublay mesh placement following low anterior resection at N.N. Blokhin Cancer Research Center between June and July 2023 were included in this pilot study. The inclusion criteria were age 18-75, TNM stage I-III, and written informed consent. The exclusion criteria included patients with synchronous and metachronous cancers, human immunodeficiency virus, an Eastern Cooperative Oncology Group score of >2, and those undergoing chemotherapy. The sublay mesh placement technique was used, with the endpoints being surgical site infection rate at 30 days, operative time, mesh placement time, and postoperative morbidity (Clavien-Dindo classification). Results: Ten patients were included in the study. Among them, one patient (10%) had a postoperative surgical site infection, which did not require mesh removal. There was no other morbidity. The median operative time was 105.5 min, whereas the median mesh placement time was 25.5 min. Conclusion: A low surgical site infection rate makes it possible to consider preventive sublay mesh placement during stoma closure. We initiated a prospective randomized clinical trial after this pilot study (ClinicalTrials.gov, NCT05939687).
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institution Kabale University
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publishDate 2024-12-01
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spelling doaj-art-006a532bec044968b74fed845d0d5edc2025-01-07T07:43:12ZengGalenos Publishing HouseTurkish Journal of Colorectal Disease2536-48982536-49012024-12-0134413013310.4274/tjcd.galenos.2024.2023-10-2Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot StudyYana Belenkaya0https://orcid.org/0000-0003-2163-1752Sergey Gordeev1https://orcid.org/0000-0002-9303-8379Nikolay Matveyev2https://orcid.org/0000-0001-9113-9400Zaman Mamedli3https://orcid.org/0000-0002-9289-1247N.N. Blokhin Russian Cancer Research Center Department of Abdominal Oncology, Moscow, Russian FederationN.N. Blokhin Russian Cancer Research Center Department of Abdominal Oncology, Moscow, Russian FederationN.N. Blokhin Russian Cancer Research Center Department of Abdominal Oncology, Moscow, Russian FederationN.N. Blokhin Russian Cancer Research Center Department of Abdominal Oncology, Moscow, Russian FederationIntroduction: There are many methods to prevent hernia following stoma closure; however, there is a lack of evidence of the efficacy of prophylactic sublay synthetic mesh placement. This study aimed to investigate the safety of sublay mesh placement during stoma closure. Methods: Patients with rectal cancer who underwent stoma closure with prophylactic sublay mesh placement following low anterior resection at N.N. Blokhin Cancer Research Center between June and July 2023 were included in this pilot study. The inclusion criteria were age 18-75, TNM stage I-III, and written informed consent. The exclusion criteria included patients with synchronous and metachronous cancers, human immunodeficiency virus, an Eastern Cooperative Oncology Group score of >2, and those undergoing chemotherapy. The sublay mesh placement technique was used, with the endpoints being surgical site infection rate at 30 days, operative time, mesh placement time, and postoperative morbidity (Clavien-Dindo classification). Results: Ten patients were included in the study. Among them, one patient (10%) had a postoperative surgical site infection, which did not require mesh removal. There was no other morbidity. The median operative time was 105.5 min, whereas the median mesh placement time was 25.5 min. Conclusion: A low surgical site infection rate makes it possible to consider preventive sublay mesh placement during stoma closure. We initiated a prospective randomized clinical trial after this pilot study (ClinicalTrials.gov, NCT05939687).https://www.turkishjcrd.com/articles/prophylactic-sublay-mesh-placement-during-stoma-closure-to-prevent-incisional-hernias-a-pilot-study/doi/tjcd.galenos.2024.2023-10-2herniastoma closuresublay meshrectal cancer
spellingShingle Yana Belenkaya
Sergey Gordeev
Nikolay Matveyev
Zaman Mamedli
Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
Turkish Journal of Colorectal Disease
hernia
stoma closure
sublay mesh
rectal cancer
title Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
title_full Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
title_fullStr Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
title_full_unstemmed Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
title_short Prophylactic Sublay Mesh Placement During Stoma Closure to Prevent Incisional Hernias: a Pilot Study
title_sort prophylactic sublay mesh placement during stoma closure to prevent incisional hernias a pilot study
topic hernia
stoma closure
sublay mesh
rectal cancer
url https://www.turkishjcrd.com/articles/prophylactic-sublay-mesh-placement-during-stoma-closure-to-prevent-incisional-hernias-a-pilot-study/doi/tjcd.galenos.2024.2023-10-2
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AT nikolaymatveyev prophylacticsublaymeshplacementduringstomaclosuretopreventincisionalherniasapilotstudy
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