Parastomal Hernia

Rubin, Marc; Schoetz, David J.; Matthews, Jeffrey B.

doi:10.1001/archsurg.1994.01420280091011

Cited by 274 publications

(48 citation statements)

References 16 publications

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“…After a parastomal incision and reduction of the hernia sac, repair involves narrowing the parastomal fascial opening by suturing the musculoaponeurotic tissues of the fascia with either absorbable or nonabsorbable suture [21]. While technically simple with low early complication rates, local repair without mesh has had high recurrence rates ranging from 10 to 76% [52]. Suture repair for a recurrent PSH has even worse results with recurrence rates as high as 100% [52,53].…”

Section: Simple Fascial Repairmentioning

confidence: 99%

“…While technically simple with low early complication rates, local repair without mesh has had high recurrence rates ranging from 10 to 76% [52]. Suture repair for a recurrent PSH has even worse results with recurrence rates as high as 100% [52,53]. This technique should be reserved only for patients with small defects in whom there is a strong desire to avoid prosthetic mesh or more extensive surgery.…”

Section: Simple Fascial Repairmentioning

confidence: 99%

“…In the only study directly comparing local tissue repair with stoma relocation, Rubin et al demonstrated that first-time PSH repair with stoma relocation was superior to simple fascial repair with recurrence rates of 33% and 76%, respectively [52]. However, the relocation of the stoma may also require a laparotomy along with all of its associated risks, and additional studies have shown a substantial risk of hernia at both the previous stoma site and the new ostomy site.…”

Section: Stoma Translocationmentioning

confidence: 99%

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Parastomal Hernia: A Growing Problem with New Solutions

et al. 2014

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Parastomal hernia is one of the most common complications following stoma creation and its prevalence is only expected to increase. It often leads to a decrease in the quality of life for patients due to discomfort, pain, frequent ostomy appliance leakage, or peristomal skin irritation and can result in significantly increased healthcare costs. Surgical technique for parastomal hernia repair has evolved significantly over the past two decades with the introduction of new types of mesh and laparoscopic procedures. The use of prophylactic mesh in high-risk patients at the time of stoma creation has gained attention in lieu of several promising studies that have emerged in the recent days. This review will attempt to demonstrate the burden that parastomal hernias present to patients, surgeons, and the healthcare system and also provide an overview of the current management and surgical techniques at both preventing and treating parastomal hernias. i 2014 S. Karger AG, Basel

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Section: Simple Fascial Repairmentioning

confidence: 99%

Section: Simple Fascial Repairmentioning

confidence: 99%

Section: Stoma Translocationmentioning

confidence: 99%

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Parastomal Hernia: A Growing Problem with New Solutions

et al. 2014

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“…The oldest and most simple technique is local suture repair of the too-wide opening in the fascia. In 3 publications [2, 9, 10] with 81 patients in total, the recurrence rate was 63% after 2 to more than 5 years of follow-up. In our opinion, this procedure should therefore be abandoned.…”

Section: Discussionmentioning

confidence: 99%

“…Although this tremendous procedure is used frequently in The Netherlands, we found only 2 publications [9, 10] with 32 patients in total. After a follow-up of 2.7 to more than 5 years, a new PCH developed in 47% of the patients and a midline or old trephine opening herniation in 52%.…”

Section: Discussionmentioning

confidence: 99%

Ring-Reinforced Prosthesis for Paracolostomy Hernia

Ruiter¹,

Bijnen²

2005

Dig Surg

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Background: The reported recurrence rate after paracolostomy hernia repair, with or without mesh, varies between 47 and 100%. We developed a polypropylene mesh prosthesis with a central opening, reinforced with a polypropylene ring, that can be implanted suprafascially through a mucocutaneous incision. Methods: The results of a consecutive series of 46 patients with paracolostomy hernia, who were implanted with this prosthesis between October 1988 and November 2000 in 12 hospitals, were analyzed. The mean follow-up was 5 (range 1–13) years. Results: The early infection rate was 4.3%. Two patients were lost to follow-up. The late infection rate was 2.3%. Seven patients (15.9%) developed a recurrent parastomal hernia and were all reoperated. The prosthesis was definitively removed in 10 patients. Conclusion: Although implantation of this new prosthesis is not without complications, it offers the lowest reported recurrence rate until now.

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Preventing Parastomal Hernia With a Prosthetic Mesh

Jänes

Cengiz²,

Israelsson³

2004

Arch Surg

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Parastomal hernia is a common complication following colostomy. The lowest recurrence rate has been produced when repair is with a prosthetic mesh. This study evaluated the effect on stoma complications of using a mesh during the primary operation.Design: Randomized clinical study.Methods: Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. The mesh used was a large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material.Results: Twenty-seven patients had a conventional stoma, and in 27 patients the mesh was used. No infection, fistula formation, or pain occurred (observation time, 12-38 months). At the 12-month follow-up, parastomal hernia was present in 13 of 26 patients without a mesh and in 1 of 21 patients in whom the mesh was used.Conclusions: A lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the stoma site is not associated with complications and significantly reduces the rate of parastomal hernia.

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Parastomal Hernia

Abstract: Parastomal hernia repair is often unsuccessful and rarely without complication. For first-time parastomal hernia repairs, stoma relocation is superior to fascial repair. For recurrent parastomal hernias, repair with prosthetic material is the most promising of a group of poor alternatives.

Cited by 274 publications

References 16 publications

Parastomal Hernia: A Growing Problem with New Solutions

Parastomal Hernia: A Growing Problem with New Solutions

Ring-Reinforced Prosthesis for Paracolostomy Hernia

Preventing Parastomal Hernia With a Prosthetic Mesh

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