Local treatment of colostomy prolapse with the MESH STRIP technique: A novel and highly efficient day hospital technique

Carlos Walter Sobrado Junior,Vivian Regina Guzela,Lucas Faraco Sobrado,Sérgio Carlos Nahas,Ivan Cecconello

doi:10.6061/clinics/2020/e1353

Abstract

OBJECTIVE:Stoma prolapse is an intussusception of the bowel through a mature stoma. It can be caused by increased intra-abdominal pressure, excessively mobile bowel mesentery and/or a large opening in the abdominal wall at the time of stoma formation. It occurs predominantly in loop stomas, and correction methods include conservative modalities, such as local reduction to the prolapsed bowel, or surgical treatment. The purpose of this study was to describe our experience with the treatment of colostomy prolapse using a novel mesh strip technique.METHODS:Between February 2009 and March 2018, ten consecutive male patients underwent correction of colostomy prolapse under local anesthesia by peristomal placement of a polypropylene mesh strip. Operation time, short- and long-term complications, and recurrence rates were recorded and analyzed.RESULTS:No postoperative complications, morbidity or mortality were observed. The median length of the prolapse ranged from 6-20 cm, and the median operative time was 30 minutes. The median duration of follow-up was 25 months (range, 12-89 months). No relapse, mesh strip extrusion, local infection or granuloma formation were found.CONCLUSION:A simple, fast, and low-cost operation under local anesthesia using a mesh strip is a valuable option to treat colostomy prolapse.

Highlights

Stoma prolapse is defined as intestinal intussusception through the stomal orifice (Figure 1)
Its prevalence varies according to type, from 8% in end colostomies to 47% in loop colostomies, with the most common prolapse occurring in the distal limb [1]
Ten consecutive male patients with stoma prolapse were selected and underwent the surgical treatment described between February 2009 and March 2018

Summary

Introduction

Stoma prolapse is defined as intestinal intussusception through the stomal orifice (Figure 1). Its prevalence varies according to type, from 8% in end colostomies to 47% in loop colostomies, with the most common prolapse occurring in the distal limb [1]. Ileostomies tend to prolapse at lower rates, with an incidence of approximately 2% [2]. The etiology of stoma prolapse is multifactorial, including increased intra-abdominal pressure caused, for example, by obesity, ascites or intracavitary expansive lesions. Mobile mesentery can contribute to prolapse formation, as can inadequate application of the colostomy/ileostomy surgical technique, with exaggerated opening of the wall for exteriorization of the loop.

Methods

Results

Conclusion