Abstract:

Parastomal hernia is one of the most common stoma related complication, with the correlated risk of incarceration, obstruction, and strangulation. The incidence is high (30–50%) and depends on the length of follow up. Different surgical options for repairing are defective with a 25–70% failure and recurrence rate. Prevention of parastomal hernia with mesh reinforcement seems to be effective. Three available trials are recruiting patients: Prism (with matrix porcine prothesis), Prevent (with preperitoneal polypropylene mesh), and the stapled polypropylene mesh stoma reinforcement technique (SMART). We performed the SMART procedure in six patients undergoing definitive colostomy. Our cases show that the procedure is rapid (duration range 15–20 minutes), cost effective (500 euro), and safe (in our experience, there are no post-surgical complications that are procedure-related). A long term follow-up and a higher number of patients will give us confirmation of the initial hopeful results.

Authors:

Simona Macina, MD, Resident, Francesca Mandolfino, MD, PhD, Specialist in General Surgery, Marco Frascio, MD, Professor of Surgery, Marco Casaccia, MD, Professor of Surgery, Cesare Stabilini, MD, PhD, Professor of Surgery, Rosario Fornaro, MD, Professor of Surgery, Tommaso Testa, MD, Consultant, Department of General Surgery, IRCCS San Martino Hospital, Genoa, Italy

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