Parastomal hernia - current knowledge and treatment.

Abstract

Intestinal stoma creation is one of the most common surgical procedures. The most common long-term complication following stoma creation is parastomal hernia, which according to some authors is practically unavoidable. Statistical differences of its occurrence are mainly due to patient observation time and evaluation criteria. Consequently, primary prevention methods such as placement of prosthetic mesh and newly developed minimally invasive methods of stoma creation are used. It seems that in the light of evidence-based medicine, the best way to treat parastomal hernia is the one that the surgeon undertaking therapy is the most experienced in and is suited to the individuality of each patient, his condition and comorbidities. As a general rule, reinforcing the abdominal wall with a prosthetic mesh is the treatment of choice, with a low rate of complications and relapses over a long period of time. The current trend is to use lightweight, large pore meshes.

Gastric Parastomal Hernia: A Case Report of a Rare yet Fascinating Clinical Entity

“…A parastomal hernia is a common complication following EC (4.0-48.1%), end ileostomy (EI) (1.8-28%), loop colostomy (LC) (0-30.8%), and loop ileostomy (LI) (0-6.2%) [2, 3]. Typically, small intestine, large intestine, and omentum are the most common organs protruding into the hernia sac; however, very rarely stomach can also herniate into the sac [2, 4]. GPH is an extremely infrequent clinical entity usually affecting the elderly female population after the 5th decade of life [7].…”

“…A parastomal hernia is a common late complication of ostomy creation, permitting gastrointestinal contents to protrude through an ostomy site [1, 2]. The overall incidence of parastomal hernia in the United States (US) is reported as ranging from 0 to 50%, with end-colostomy (EC) having the highest incidence rate of 4.0-48.1% [3].…”

Internal Hernia Associated with Colostomy After Laparoscopic Surgery for Rectal Malignancy: A Report of 3 Thought-Provoking Cases

“…Though parastomal hernia is a common complication after colostomy [13,14], intraperitoneal internal hernia and parastomal hernia are different. We here focused on a rare complication (i.e., IHAC).…”

“…Our technical solution for not only IHAC but also parastomal hernia are summarized in schema (Figure 4). Colostomy is created via an extraperitoneal route to prevent IHAC even in fewer adhesions by laparoscopic surgery, and via staggered fascia incisions to avoid the most common complication (i.e., parastomal hernia) [13,14].…”

Development and evaluation of a patient decision aid for patients considering ongoing medical or surgical treatment options for ulcerative colitis using a mixed-methods approach: protocol for DISCUSS study

“…The impact on lifestyle of these two choices cannot be understated—reconstructive surgery will avoid a stoma, with an acceptance of potential complications such as increased stool frequency, pouchitis or faecal incontinence 9. A stoma may offer more control over excretory functions, but is associated with complications such as parastomal hernia, as well as psychological sequelae 10 11. When selecting a treatment option, it is clear that the patient must select the option based on their preferences.…”