Parastomal Hernia Repair Outcomes: A Nine-Year Experience

Lin, You Wei; Keller, Patrick; Davenport, Daniel L.; Plymale, Margaret A.; Totten, Crystal; Roth, J. Scott

doi:10.1177/000313481908500734

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…In regard to repairs, previous groups, including the European Hernia Society, have established standardized classification systems for parastomal hernias . Repair of larger type III and type IV parastomal hernias was not associated with a higher rate of recurrence in a small, single-institution cohort . In the current study, recurrent parastomal hernia rates were decreased with the use of mesh or myofascial release.…”

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confidence: 44%

“…4 Repair of larger type III and type IV parastomal hernias was not associated with a higher rate of recurrence in a small, single-institution cohort. 5 In the current study, recurrent parastomal hernia rates were decreased with the use of mesh or myofascial release. Whether these techniques were required due to the size and complexity of the hernia is unknown and would be an important consideration when applying these conclusions to future patients.…”

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confidence: 49%

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Long-term Outcomes of Parastomal Hernia Repair—The Defect in Knowledge (and Abdominal Wall) Remains

2023

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Parastomal hernias pose a challenging surgical problem without clear treatment paradigms due to a lack of high-quality evidence. In their study in this issue of JAMA Surgery, Howard et al 1 evaluated long-term recurrence of incisional and parastomal hernias after elective parastomal hernia repair in a national cohort of elderly patients. The authors creatively used Medicare claims data, resulting in a well-powered study that demonstrated that patients who had their ostomies reversed had the lowest rate of recurrent hernias. As the authors point out, the large sample size is offset by the lack of granularity, making it difficult to incorporate patient characteristics into surgical planning such as defect size, quality of the abdominal domain, and candidacy for ostomy reversal.Although this was not the focus of this study, prevention of hernia is a key issue to address. Correct sizing and placement of the ostomy defect is paramount, yet hernias still occur. Prophylactic mesh placement at the time of ostomy creation in the STOMAMESH trial failed to show differences in hernia development. 2 The finding that resiting an ostomy may be inferior to local repair is informative as it suggests that we can avoid what may be a more involved operation that creates an additional abdominal wall defect. However, the decision to resite possibly implies that the fascia at the original ostomy site was unsalvageable or may have failed a previous repair. This is a difficult issue to address regardless of study design as there is no objective, quantifiable definitions for the character of the stomal defect in relation to the quality of the surrounding abdominal wall or loss of domain. 3 In regard to repairs, previous groups, including the European Hernia Society, have established standardized classification systems for parastomal hernias. 4 Repair of larger type

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confidence: 44%

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confidence: 49%

Long-term Outcomes of Parastomal Hernia Repair—The Defect in Knowledge (and Abdominal Wall) Remains

2023

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“…Лікування даної хвороби тільки оперативне, навіть незважаючи на використання сітки рецидиви захворювання сягають до 26 %. Середня тривалість без рецидивного періоду становила 3,9 року [8].…”

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Choosing a Method of Surgical Treatment of Paraknolostomy Hernias in Patients With Obesity

Vorovskiy¹,

Shaprinskiy²,

Shaprinskiy³

et al. 2020

Khark. Surg. Sch.

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Smmary. The aim of the work was to solve the problem of preventing and choosing the method of surgical treatment of paracolostomy hernia in patients with obesity. Materials and research methods. The treatment results of 56 (100.0 %) patients with obesity operated on for paracolostomy hernia were analyzed. Men made up 27 (56.2 %) people, women - 29 (29.0 %). In all patients of this age category, except for obesity, there was a combined concomitant pathology: atherosclerotic and post-infarction cardiosclerosis — in 56 (100.0 %) cases; COPD - in 42 (69.6 %); diabetes mellitus — in 18 (26.1 %); cerebrosclerosis — in 17 (24.6 %). Surgical treatment of paracolostomy hernias was performed by 3 methods: alloernioplasty with colostomy left in the same place was performed in 16 (29.0 %) patients; allohernioplasty with colostomy moving to a new place — 22 (52.2 %) patients; 18 (18.2 %) used minimally invasive methods, of which 8 (11.6 %) using the laparoscopically-assisted method. The average duration of laparoscopic hernioplasty was (65.5 ± 5.5) minutes., With «open» methods — (45.5 ± 5.5) minutes Research results. The analysis of the results of treatment of paracolostomy hernias with three different methods was carried out; the groups were identical in terms of the number of patients. According to the duration of the operation, the laparoscopic method of alloernioplasty was longer and needed the use of general anesthesia and pneumoperitoneum, which can cause the development of a number of dangerous complications. The other two extraperitoneal methods of allogeneioplasty are more gentle, can be performed under spinal or epidural anesthesia. However, it is precisely with these methods of alogioplasty that the risk of developing local complications is high. Conclusions. In the treatment of paracolonostomy hernias in patients with obesity, the best results were obtained with laparoscopic alloernioplasty. When withdrawing a colostomy in patients of advanced and senile age, preventive alloprosthetics are recommended.

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Laparoscopic Keyhole Versus Sugarbaker Repair in Parastomal Hernia: A Long-Term Case-Controlled Prospective Study of Consecutive Patients

Gameza

Lybecker

Wara

2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Parastomal Hernia Repair Outcomes: A Nine-Year Experience

Cited by 4 publications

References 14 publications

Long-term Outcomes of Parastomal Hernia Repair—The Defect in Knowledge (and Abdominal Wall) Remains

Long-term Outcomes of Parastomal Hernia Repair—The Defect in Knowledge (and Abdominal Wall) Remains

Choosing a Method of Surgical Treatment of Paraknolostomy Hernias in Patients With Obesity

Laparoscopic Keyhole Versus Sugarbaker Repair in Parastomal Hernia: A Long-Term Case-Controlled Prospective Study of Consecutive Patients

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