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ORIGINAL RESEARCH article

Front. Surg.
Sec. Visceral Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1479870

Surgeons' opinions and concerns regarding prophylactic mesh placement when conducting a permanent ileo-and colostomy A survey among 172 surgeons in Germany, Switzerland, and Austria

Provisionally accepted
Christoph Paasch Christoph Paasch 1Egan Leonidovich Kalmykov Egan Leonidovich Kalmykov 2,3*Ralph Lorenz Ralph Lorenz 1Nele Neveling Nele Neveling 1Rene Mantke Rene Mantke 1
  • 1 Department of Surgery, Municipal Hospital Brandenburg GmbH, Brandenburg, Germany
  • 2 Other, Brandenburg an der Havel, Germany
  • 3 Department of Vascular and Endovascular Surgery, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany

The final, formatted version of the article will be published soon.

    Background Prophylactic mesh placement when creating a permanent colostomy was recommended by the 2017 European Hernia Society guidelines on the prevention and treatment of parastomal hernias (GPTPH2017). The extent of this recommendation is under debate based on the long-term data from clinical trials. Our aim was to conduct a survey of surgeons revealing perspectives and concerns regarding GPTPH2017 and to discuss their concerns.Methods From January 2023 to September 2023 a survey among surgeons of Germany, Switzerland and Austria was conducted. The questionnaire addressed demographic data of the participants, information on work experience/location, number of elective permanent colo-and ileostomies, and opinions on the recommendation of GPTPH2017 for prophylactic mesh placement.Results A total of 172 surgeons from Germany, Austria and Switzerland answered the questionnaire and 59 of them stated professional experience of 20-30 years. Most of the surgeons (n=51, 31.3%) worked in a primary care hospital. A total of 112 participants were familiar with the GPTPH2017. Sixty-five surgeons (40%) stated that they never conduct a prophylactic mesh placement when creating an elective permanent colostomy (rarely, n=44 (26.7%). Seven participants always place a mesh (4.2%, missing data: 7). Main concerns regarding prophylactic mesh placement was the concern of surgeons about wound infection (n=107, 67.7%) and lack of evidence (n=65, 41.1%). For some participants the GPTPH2017 is seen to be industry-driven with low evidence, too old and leading to overtreatment.The main reason for not placing a prophylactic mesh when conducting a permanent colostomy was the risk of wound infection.

    Keywords: Parastomal hernia, guideline, Non-absorbable mesh, prophylactic mesh placement, herrnia

    Received: 12 Aug 2024; Accepted: 18 Oct 2024.

    Copyright: © 2024 Paasch, Kalmykov, Lorenz, Neveling and Mantke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Egan Leonidovich Kalmykov, Other, Brandenburg an der Havel, Germany

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