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EFFICIENCY OF PLACEMENT OF PROPHYLACTIC MESH USING SUGARBAKER TECHNIQUE DURING LAPAROSCOPIC ABDOMINOPERINEAL RESECTION FOR RECTAL CANCER
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Abstract
Aims: The study aim was to evaluate efficiency of parastomal hernia prevention through placement of a prosthetic mesh using Sugarbaker technique during laparoscopic abdominoperineal resection for rectal cancer after 1 year follow up at University Medical Center, Ho Chi Minh City. Methods: Intervention study. Between 11/2018 and 7/2023, a total of 56 patients with low rectal cancer underwent laparoscopic abdominoperineal resection and divided into two groups: intervention group with prophylactic mesh placement using Sugarbaker technique (n = 28) and control group without prophylactic mesh placement (n = 28). All patients were followed at least 12 months and had abdominal computed tomography scan. Kaplan Meier method was used to analyze rate of parastomal hernia at 1 year. The logrank test was used to compare rate of parastomal hernia between two groups. Results: There were 56 patients included in this study, the male to female ratio was approximately equal to 1:1, the median age was 62, youngest age 40, oldest age 92. Incidence of rectal cancer stage III was 44,6%. The rate of neoadjuvant chemoradiotherapy was 26,7%. The median operating time was 184 minutes. The median mesh placement time was 15 minutes. Total complications rate was 16,4%. There were no mesh placement-related complications. The cumulative rate of a parastomal hernia at 1 year in control group was higher than intervention group (35.7% versus 0%, logrank 6.4, p=0.01). Conclusions: Prophylactic mesh placement using Sugarbaker technique during laparoscopic abdominoperineal resection for rectal cacner is safe, does not increase complications and decrease the cumulative rate of a parastomal hernia at 1 year in patients undergoing prophylactic mesh placement using Sugarbaker technique
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Keywords
Prophylactic mesh placement, Sugarbaker technique, Laparoscopic abdominoperineal resection
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