Repair of peristomal colostomy hernias

Outcome of parastomal hernia repair with and without midline laparotomy

“…Later herniation may result from gradual stretching of the fascial defect [16], perhaps contributed to by advanced age, obesity and increased abdominal pressure.…”

A direct approach for the treatment of parastomal hernias using a prosthesis

“…Surgical indications are rarely imposed as the herniation is often of a small size, non progressive and consequently, seldom incapacitating [Cevese et al 1984]. Only the hernias which are not situated about the stoma are exposed to the risk of strangulation and should be preferentially operated upon [Priam and Sawyer 1975]. The same reasoning applies to situations where intestinal transit is affected by the voluminous size of the parastomal hernia or difficulties in stoma care, particularly in the presence of an associated prolapse.…”

“…Some authors nevertheless suggest an incidence of parietal reconstruction of the order of 25% [Ortiz et al 1994, Priam andSawyer 1975]. [CuiUeret et al 199o, Leslie 1984].…”

Parastomal Hernia

“…A 2012 systematic review by Hansson et al deemed fascial repair outdated due to an overall morbidity rate of 22.6, 11.8 % surgical site infection and 69.4 % rate of recurrent PH [68]. Stoma relocation can result in recurrent PH in 0-76.2 % of patients [3,[64][65][66][69][70][71]. Stoma relocation can carry the added risk of a laparotomy and thus create three potential sites for hernia formation; however, in one series, 76 % of stoma relocation cases were successfully accomplished without a laparotomy [64].…”