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Mesh at Stoma Site During Bladder Cancer Surgery May Not Prevent Future Hernias

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Evaluating Benefits of Peristomal Mesh Placement at the Time of Radical Cystectomy and Ileal Conduit Formation A Phase 3, Randomized Controlled Trial DOI- 10.1097JU.00000000

People who undergo bladder removal surgery (radical cystectomy) often have their urine diverted through a small opening in the abdomen called a stoma. This is done using a piece of intestine, called an ileal conduit. One common problem after this surgery is the development of a parastomal hernia—when the intestine pushes through weak spots around the stoma. These hernias can cause discomfort, affect daily life, and sometimes require another operation.

Doctors have been trying to find ways to stop these hernias from forming. One idea was to place a special mesh near the stoma during surgery. This mesh is meant to strengthen the area and reduce the chance of hernias forming later. A new study looked at whether this approach really works.

In this large study, some patients had the mesh placed during their bladder surgery, while others did not. After 2 years, the results showed that patients with the mesh had hernias just as often as those without it. In fact, the group with mesh had slightly more hernias, but this difference was not large enough to be considered important.

The researchers concluded that placing mesh at the time of stoma creation does not lower the risk of future hernias. This means there is no clear benefit from using mesh during this type of bladder cancer surgery. Doctors may now choose to avoid using mesh in these cases, helping to keep the surgery simpler and safer.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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