Technique, feasibility and perioperative outcomes of robotic parastomal hernia repair with biologic mesh after cystectomy and ileal conduit diversion

Shakir, Aliasger; Ghoreifi, Alireza; Ashrafi, A.N.; Berger, André; Aron, Manju; Djaladat, Hooman

doi:10.1016/s2666-1683(20)34205-1

Cited by 2 publications

(12 citation statements)

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“…1 ). Authors were contacted to provide additional data on 15 conference abstracts [ 13 – 27 ] and 9 full-text articles with subgroups of ileal conduit patients [ 28 – 36 ]. However, no additional data was available or provided.…”

Section: Resultsmentioning

confidence: 99%

“…An overview of study characteristics, surgical details and postoperative outcomes is shown in Table 1 . Details on five conference abstracts that met the inclusion criteria are depicted in Table 2 [ 23 – 27 ]. Studies reporting on the use of prophylactic mesh in the prevention of ileal conduit parastomal hernia are summarized in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

“…All studies were retrospective. Most data comes from European [ 25 , 26 , 37 – 39 , 45 ] and North-American centers [ 23 , 27 , 40 – 42 ]. One conference abstract is from India [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Techniques described in the full-text papers were onlay mesh repair covering only the lateral part of the stoma (n = 15) [ 39 ], onlay mesh repair with a non-specified technique (n = 20) [ 44 ], relocation (n = 38) [ 37 , 41 ], keyhole technique (n = 29) [ 40 , 42 , 43 ], Sugarbaker repair (n = 10) [ 43 ] and use of a 3D-funnel-shapedmesh (n = 40) [ 38 ]. Additionally, in conference abstracts the keyhole-technique (n = 7) [ 27 ], and 3D-funnel-shaped mesh (n = 13) [ 26 ] were presented. Two conference abstracts described their technique as ‘intraperitoneal mesh’ and ‘laparoscopic repair’, but did not further specify their technique [ 23 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two conference abstracts described their technique as ‘intraperitoneal mesh’ and ‘laparoscopic repair’, but did not further specify their technique [ 23 , 25 ]. Approaches used were predominantly open (n = 137) [ 26 , 37 – 41 , 43 , 44 ], laparoscopic (n = 49) [ 23 , 25 , 42 – 44 ], and robot-assisted (n = 13) [ 24 , 27 ]. Mesh placement was performed in all studies, the mesh position was either onlay (n = 60) [ 39 – 41 , 44 ] or intraperitoneally (n = 99) [ 24 – 27 , 37 – 39 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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Parastomal hernias after cystectomy and ileal conduit urinary diversion: surgical treatment and the use of prophylactic mesh: a systematic review

et al. 2022

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Background Parastomal hernia after ileal conduit urinary diversion is an underestimated and undertreated clinical entity, which heavily impairs patients’ quality of life due to symptoms of pain, leakage, application or skin problems. As for all gastrointestinal stomata the best surgical repair technique has yet to be determined. Thereby, surgery for ileal conduit parastomal hernias poses some specific perioperative challenges. This review aims to give an overview of current evidence on the surgical treatment of parastomal hernia after cystectomy and ileal conduit urinary diversion, and on the use of prophylactic mesh at index surgery in its prevention. Methods A systematic review was performed according to PRISMA-guidelines. The electronic databases Embase, PubMed, Cochrane Library, and Web of Science were searched. Studies were included if they presented postoperative outcomes of patients undergoing surgical treatment of parastomal hernia at the ileal conduit site, irrespective of the technique used. A search was performed to identify additional studies on prophylactic mesh in the prevention of ileal conduit parastomal hernia, that were not identified by the initial search. Results Eight retrospective case-series were included for analysis, reporting different surgical techniques. If reported, highest complication rate was 45%. Recurrence rates varied highly, ranging from 0 to 80%. Notably, lower recurrence rates were reported in studies with shorter follow-up. Overall, available data suggest significant morbidity after the surgical treatment of ileal conduit parastomal hernias. Data from five conference abstracts on the matter were retrieved, and systematically reported. Regarding prophylactic mesh in the prevention of ileal conduit parastomal hernia, 5 communications were identified. All of them used keyhole mesh in a retromuscular position, and reported on favorable results in the mesh group without an increase in mesh-related complications. Conclusion Data on the surgical treatment of ileal conduit parastomal hernias and the use of prophylactic mesh in its prevention is scarce. Given the specific perioperative challenges and the paucity of reported results, more high-quality evidence is needed to determine the optimal treatment of this specific surgical problem. Initial results on the use of prophylactic mesh in the prevention of ileal conduit parastomal hernias seem promising.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Parastomal hernias after cystectomy and ileal conduit urinary diversion: surgical treatment and the use of prophylactic mesh: a systematic review

et al. 2022

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Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

et al. 2021

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Objective To investigate the incidence, risk factors and natural history of parastomal hernia (PSH). Materials and Methods We reviewed the records of patients who underwent radical cystectomy (RC) and ileal conduit (IC) procedure between 2007 and 2020. Patients who had available follow‐up computed tomography (CT) imaging were included in this study. All CT scans were re‐reviewed for detection of PSH according to Moreno‐Matias classification. Patients who developed hernia were followed up and classified into stable or progressive (defined as radiological upgrading and/or need for surgical intervention) groups. Multivariable Cox regression was performed to identify independent predictors of hernia development and progression. Results A total of 361 patients were included in this study. The incidence of radiological PSH was 30%, graded as I (56.5%), II (12%) and III (31.5%). The median (interquartile range [IQR]) time to radiological hernia was 8 (5–15) months. During the median (IQR) follow‐up of 27 (13–47) months in 108 patients with a hernia, 26% patients progressed. The median (IQR) time to progression was 12 (6–21) months. On multivariable analysis, female gender (hazard ratio [HR] 1.86), diabetes (HR 1.81), chronic obstructive pulmonary disease (COPD; HR 1.78) and higher body mass index (BMI; HR 1.07 for each unit) were independent predictors for radiological PSH development. No significant factor was found to be associated with hernia progression. Conclusion Radiological PSH after RC and IC occurred in 30% of patients, a quarter of whom progressed in a median time of 12 months. Female gender, diabetes, COPD and high BMI were independent predictors for radiological hernia development.

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Technique, feasibility and perioperative outcomes of robotic parastomal hernia repair with biologic mesh after cystectomy and ileal conduit diversion

Cited by 2 publications

References 0 publications

Parastomal hernias after cystectomy and ileal conduit urinary diversion: surgical treatment and the use of prophylactic mesh: a systematic review

Parastomal hernias after cystectomy and ileal conduit urinary diversion: surgical treatment and the use of prophylactic mesh: a systematic review

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

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