Effectiveness of placing prophylactic mesh with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer

Abstract

Introduction: The aim of this study was to assess the efficacy of parastomal hernia prevention with the Sugarbaker technique via laparoscopic abdominoperineal resection for rectal cancer after a one-year follow-up at University Medical Center in Ho Chi Minh City.

Patients and methods: Intervention study. Between 11/2018 and 7/2022, 43 patients with low rectal cancer underwent laparoscopic abdominoperineal resection and were divided into two groups: intervention (n = 15) with prophylactic mesh placement using the Sugarbaker technique and control (n = 28). All patients were tracked for at least a year and had an abdominal computed tomography scan. The Kaplan Meier method was used to calculate the rate of parastomal hernia after one year. To compare the rates of parastomal hernia in two groups, the logrank test was used.

Results: This study included 43 patients; the male to female ratio was approximately equal to 1:1; the median age was 62; the youngest age was 40; and the oldest age was 92. Rectal cancer stage III was found in 41.8% of people. Neoadjuvant chemoradiotherapy was used in 27.9% of cases. The average duration of operation was 184 minutes. The average time for mesh placement was 15 minutes. The overall complication rate was 16.4%. There were no issues with mesh placement. At one year, the control group had a higher cumulative rate of parastomal hernia than the intervention group (35.7% versus 0%, logrank 6.4, p = 0.01).

Conclusions: Prophylactic mesh placement using the Sugarbaker technique during laparoscopic abdominoperineal resection for rectal cacner is safe, does not increase complications, and reduces the cumulative rate of a parastomal hernia at 1 year in patients who have undergone prophylactic mesh placement.

Keywords: Prophylactic mesh placement, Sugarbaker technique, Laparoscopic abdominoperineal resection.

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