{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:39:48Z","timestamp":1764002388610,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T00:00:00Z","timestamp":1604793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Parastomal hernias occur in 50\u201380% after stoma formation. Even with mesh repairs, recurrence can be as high as 33%. Stapled Mesh stomA Reinforcement Technique (SMART) places a prophylactic onlay mesh in the trephine during permanent stoma formation to prevent parastomal hernia. Our study aims to describe the short\u2010term outcomes of SMART procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study of patients receiving the SMART procedure from 2015 to 2020 was conducted. Inclusion criteria: non\u2010Crohn's colorectal and urological surgery with permanent stoma formation. The SMART surgical technique incorporates a 70\u2010mm circular piece of polypropylene mesh by stapling it to the muscular abdominal wall using a circular stapler, and attaching the edge of the mesh to the deep fascia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients had a total of 53 SMART procedures. Median follow\u2010up was 27\u2009months. Procedures included: 35 end colostomies, five end ileostomies, eight ileal urinary conduits and five double\u2010barrelled wet colostomies. Four patients had parastomal hernia during follow\u2010up. One was acute, on day 1, due to very large size of trephine, one in a double\u2010barrelled wet stoma that was repaired laparoscopically, one had a stomal prolapse requiring revision at 3\u2009years and one patient had early small bowel obstruction due to very small size of trephine requiring another surgery. There were no wound infections or mesh\u2010related sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Symptomatic parastomal herniation occurred in 8% of the study population, and most complications were due to incorrect choice of stapled trephine diameter. Longer term follow\u2010up is required to assess for problematic parastomal hernia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16420","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T07:19:49Z","timestamp":1604906389000},"page":"1185-1189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Short\u2010term outcomes of parastomal hernia prophylaxis with Stapled Mesh <scp>stomA<\/scp> Reinforcement Technique (<scp>SMART<\/scp>) in permanent stomas"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9548-9720","authenticated-orcid":false,"given":"Michelle Zhiyun","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Macquarie University  Sydney New South Wales 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