Surgical treatment of parastomal hernia complicating sigmoid colostomies

Cheung, Moon‐Tong; Chia, Nam-Hung; Chiu, Wai-Yip

doi:10.1007/bf02234303

Cited by 147 publications

(126 citation statements)

References 13 publications

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“…Generally, the techniques fall into one of three categories: local tissue repair, stoma relocation, or repair with prosthetic material [3]. Although clinical trials to compare one technique with the others have never been performed, it is now commonsense to regard techniques using local tissue repair as outdated because of the high recurrence rates in most studies [1,4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Stoma relocation may seem to be an attractive alternative, but it has some major drawbacks such as the risk for the development of a parastomal hernia at the new stoma site and an incisional hernia at the old stoma site [5,17]. In addition, this technique requires a formal relaparotomy, causing further damage to the abdominal wall, thereby introducing the risk of an incisional hernia at this particular site.…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence varies significantly, but may be as high as 48% for colostomies and 28% for ileostomies [3]. Many operative techniques have been proposed for correction of parastomal hernias, but to date, none has been able to provide satisfactory results, especially in the long term [3,5].…”

mentioning

confidence: 99%

“…There is growing evidence that herniation in general results from an intrinsic defect in collagen metabolism and wound repair [9,16], and that this together with mechanical factors and a high wound complication rate probably explains the high recurrence rates obtained with techniques relying on primary hernia repair alone [1,4,5]. This has resulted in the introduction of prosthetic meshes to correct fascial defects, and randomized clinical studies have indeed proven the superiority of prosthetic meshes in the repair of inguinal [7] and incisional [2,12] hernias, making their usage almost obligatory in these cases.…”

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confidence: 99%

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Laparoscopic parastomal hernia repair is feasible and safe: early results of a prospective clinical study including 55 consecutive patients

Hansson

Hingh

Bleichrodt³

2007

Surg Endosc

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Background: Parastomal herniation is a common complication, and its operative treatment is notoriously difficult. Recently, the authors have described a laparoscopic technique for closure and reinforcement of the hernia with a hand-made ''funnel-shaped'' Gore-Tex Dual Mesh. Potentially this technique combines the advantages of a mesh repair with those of minimal invasive surgery. Methods: In 2002, a multicenter trial of this new technique was started in The Netherlands. To date, 55 consecutive patients (27 men; median age, 63 years) with a symptomatic primary (n = 45) or recurrent (n = 10) parastomal hernia have undergone elective surgery using this technique. The demographic, perioperative, and early follow-up data prospectively collected for these patients are presented in this report. Results: Of the 55 procedures, 47 (85.5%) could be completed laparoscopically (median operation time, 120 min). Conversion to laparotomy was indicated because of dense adhesions prohibiting safe dissection (n = 4) or bowel injury (n = 4). No in-hospital mortality occurred. Postoperative recovery was uneventful for 47 patients (85%), who had a median hospital stay of 4 days. Surgical and nonsurgical complications occurred, respectively, for four patients each (7.2%). Full-thickness enterotomy appeared to be the most troublesome complication. After 6 weeks, when all the patients were reexamined, one recurrence was noted. Conclusion: Maximal efforts should be undertaken to prevent perioperative full-thickness enterotomy. Because this was achieved for the vast majority of patients, it is concluded that laparoscopic parastomal hernia repair is feasible and safe. Although a longer follow-up period is needed for definitive conclusions to be drawn regarding the recurrence rate, early follow-up evaluation shows very promising results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Laparoscopic parastomal hernia repair is feasible and safe: early results of a prospective clinical study including 55 consecutive patients

Hansson

Hingh

Bleichrodt³

2007

Surg Endosc

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“…Paraestomal hernia is a type of incisional hernia that occurs at the site of the stoma 7 . Represents the most common complication associated with the production of intestinal stoma.…”

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confidence: 99%

Manejo das hérnias paraestomais

Araújo¹,

Seid²,

Campos³

et al. 2011

ABCD, arq. bras. cir. dig.

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INTRODUÇÃO: A hérnia paraestomal representa complicação tardia de virtualmente todos os estomas intestinais. As manifestações clínicas oscilam desde um simples problema estético até o estrangulamento do conteúdo herniado. O grau de incapacidade produzido pela hérnia é variável. Existe gama muito grande de procedimentos utilizando ou não material protético de variada especificidade e de resultados controversos. MÉTODOS: Foi realizada revisão de literatura nos sites de pesquisa PubMed, Bireme e Scielo, com os descritores hérnias paraestomais, tratamento cirúrgico, hérnia, colostomia e ileostomia. Selecionaram-se, principalmente, os estudos de aplicação de técnicas cirúrgicas e adicionou-se a experiência clínica dos autores. CONCLUSÃO: Apesar das várias técnicas e meios à disposição do cirugião para o manuseio das hérnias paraestomais, ainda não há método ideal que venha a ser recomendado para todos os casos. Assim, a análise criteriosa dos fatores de riscos do paciente pode ajudar a escolher a melhor opção de tratamento que deve ser individualizada a cada caso.

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