Parastomal hernias

Pearl, Russell K.

doi:10.1007/bf01658872

Cited by 162 publications

(107 citation statements)

References 15 publications

(19 reference statements)

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“…Risk factors for PH are similar to those observed for other hernias of the abdominal wall, including obesity, weight gain after ostomy creation, advanced age, malnutrition, increased intra-abdominal pressure, long-term use of immunosuppressive drugs, chronic lung disease, malignancy, history of large hernias, emergency operation and postoperative infection [1]. Risk of recurrence is also higher in these patients.…”

Section: Introductionsupporting

confidence: 59%

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Repair of complex parastomal hernias

et al. 2015

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Development of parastomal hernias (PH) is very common after stoma formation and carries a risk of subsequent bowel incarceration, obstruction and strangulation. The management of PH remains a challenge for the colorectal surgeon, and there are currently no standardized guidelines for the treatment of PH. Even more difficult is the management of complex parastomal hernias (CPH). We conducted a review of the literature to identify recent developments in the treatment of CPH, including analysis of the use of synthetic and biologic mesh prostheses, method of mesh placement and surgical approach.

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Section: Introductionsupporting

confidence: 59%

“…Parastomal hernia (PH) is defined as an incisional hernia in the context of an abdominal wall stoma [1]. It is one of the most frequent complications following the creation of a stoma.…”

Section: Introductionmentioning

confidence: 99%

Repair of complex parastomal hernias

et al. 2015

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“…Una hernia paraestomal (HP) es una eventración del estoma 1 . La Sociedad Europea de Hernia (EHS, por sus siglas en inglés) la define como una protrusión anormal del contenido de la cavidad abdominal a través de un defecto de la pared abdominal creado durante la realización de una colostomía o ileostomía 2 .…”

Section: Definición Y Prevalenciaunclassified

“…La Sociedad Europea de Hernia (EHS, por sus siglas en inglés) la define como una protrusión anormal del contenido de la cavidad abdominal a través de un defecto de la pared abdominal creado durante la realización de una colostomía o ileostomía 2 . Es una complicación frecuente 1,3 y, según algunos autores, inevitable 4 . Tiene una elevada prevalencia (entre 0 % y 56 % según la bibliografía publicada 3,5,6 ), pero es difícil estimar su prevalencia real por el uso de definiciones 6,7,8,9 y criterios diagnósticos diferentes en función del grupo 7,8,9 .…”

Section: Definición Y Prevalenciaunclassified

Actualización de las hernias paraestomales: diagnóstico, tratamiento y prevención

Pallisera‐Lloveras

Serra‐Aracil²,

Mora³

et al. 2017

Rev Hispanoam Hernia

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La hernia paraestomal es una complicación frecuente, con una prevalencia real difícil de estimar debido a la heterogeneidad de los estudios. Existe cierta falta de consenso en cuanto a su tratamiento. Por eso, su prevención es un asunto controvertido y de amplio interés, y se considera la mejor estrategia ante la realización de un estoma permanente.Este trabajo pretende realizar una actualización en el diagnóstico, tratamiento y prevención de esta patología y una comparación con la experiencia del grupo. La elección de la técnica quirúrgica dependerá de la urgencia quirúrgica. En cirugía urgente, si el estado del paciente es crítico o existe necrosis intestinal, se aconseja reparación simple del defecto. Para el resto de los escenarios, el tratamiento con malla es el recomendado. En caso de cirugía electiva en un grupo con experiencia, se aconseja la reparación laparoscópica intraperitoneal mediante la técnica Sugarbaker. En caso de urgencias o cirugía electiva abierta, los resultados entre las técnicas keyhole y Sugarbaker son similares. En cuanto a la prevención, el papel del estomatoterapeuta es de gran importancia: permite un correcto marcaje del estoma, la aplicación de medidas preventivas y el inicio de un tratamiento conservador precoz. A falta de estudios defi nitivos, creemos que la prevención con malla intraperitoneal laparoscópica mediante la técnica de Sugarbaker es la técnica recomendada. Aún así, se necesitan ensayos prospectivos aleatorizados que comparen las diferentes técnicas, que estratifi quen el riesgo de hernia paraestomal y que identifi quen aquellos pacientes tributarios de colocación de una malla profi láctica.

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“…1 Parastomal hernia (PH), defined as an "incisional hernia related to an abdominal wall stoma", is one of the most frequent complications following stoma formation and has a negative impact on quality of life after RC. [2][3][4] Its incidence varies widely depending on the definition used, the length of follow-up, and whether the diagnosis is made clinically or radiographically. 4 Up to 30% of patients with PH require surgical intervention, most commonly due to discomfort, poor fit of the ostomy appliance, or rarely due to obstruction, bowel perforation, or strangulation.…”

Section: Introductionmentioning

confidence: 99%

1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

et al. 2013

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Purpose-Parastomal hernia (PH) is a frequent complication from stoma formation after radical cystectomy (RC). We sought to determine the prevalence and risk factors for developing PH following RC.Material and Methods-Retrospective study of 433 consecutive patients who underwent open RC and ileal conduit between 2006-2010. Postoperative cross-sectional imaging studies performed for routine oncologic follow-up (n=1736) were evaluated for PH, defined as radiographic evidence of protrusion of abdominal contents through the abdominal wall defect created by forming the stoma. Univariable and multivariable Cox regression analyses were used to determine clinical and surgical factors associated with PH.Results-Complete data were available for 386 patients with radiographic PH occurring in 136. The risk of developing a PH was 27% (95% CI 22-33%) and 48% (95% CI 42-55%) at 1 and 2 years. Clinical diagnosis of PH was documented in 93 patients and 37 were symptomatic. Of 16 patients with clinical PH referred for repair, 8 had surgery. On multivariable analysis, female gender (HR=2.25, 95%CI 1.58-3.21; p<0.0001), higher BMI (HR=1.08 per unit increase 95%CI 1.05-1.12; p<0.0001), and lower preoperative albumin (HR=0.43 per g/dl, 95%CI 0.25-0.75; p=0.003) were significantly associated with PH.Conclusions-The overall risk of radiographic evidence of PH approached 50% at 2 years. Female gender, higher BMI, and lower preoperative albumin were most associated with developing PH. Identifying those at greatest risk may allow for prospective surgical maneuvers at the time of initial surgery, such as placement of prophylactic mesh in selected patients, to prevent the occurrence of PH.

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Parastomal hernias

Cited by 162 publications

References 15 publications

Repair of complex parastomal hernias

Repair of complex parastomal hernias

Actualización de las hernias paraestomales: diagnóstico, tratamiento y prevención

1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

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