Abstract
PurposeTo determine whether prophylactic mesh in a sublay position has an impact on the quality-of-life (QoL) of patients receiving an end colostomy.MethodsOne-year follow-up of patients from the STOMAMESH trial, a randomized controlled double-blinded multicenter study. Patients were randomized to either prophylactic synthetic mesh with a cruciform incision in the center, placed in sublay position, or no prophylactic mesh. Patients attended a 1-year visit and responded to the questionnaires EORTC QLQ C-30 and CR-38. The impact of having a mesh on QoL was determined by comparing a group of patients receiving a mesh with a group without. A subgroup analysis was made depending on whether a PSH was clinically present or not.ResultsOf the 232 randomized patients, 211 patients reached the 1-year clinical follow-up. The response rate of these 211 patients was 70%. No differences were seen in global QoL between the groups. Mesh patients reported significantly less stoma-related problems (p = 0.014) but more sexual problems in males (p = 0.022). When excluding patients with a clinical diagnosis of PSH, the difference in stoma-related problems remained while no significant difference was seen regarding sexual problems in males.ConclusionsWhen forming an end colostomy, prophylactic synthetic mesh in a sublay position did not affect global QoL at 1-year follow-up, but stoma-related problems were fewer even in the presence of a clinically diagnosed PSH.Trial registrationNCT00917995
Highlights
The presence of a stoma has a negative impact on qualityof-life (QoL) [1,2,3]
There were no significant differences between the groups regarding occurrence of parastomal hernia (PSH), bulging only, stenosis, prolapse, or stoma dressing problems
There were no differences in occurrence of other stoma-related complications such as stenosis, prolapse, and dressing problems. These results suggest that prophylactic synthetic mesh in sublay position significantly reduces stoma-related problems in ways other than reduction in any of the above
Summary
The presence of a stoma has a negative impact on qualityof-life (QoL) [1,2,3]. Complications arising from a stoma are common and varied; parastomal hernia (PSH) being one of the most frequent and important of these [4]. Stenosis, intestinal obstruction, retraction, prolapse, and skin complications [4,5,6,7]. Stomarelated problems are both physical and psychological [8, 9]. If a PSH or bulge is present, the patient’s quality of life is reduced even more [3]
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