O21 EVALUATION OF THE TREATMENT OF PARASTOMAL HERNIA IN THE NETHERLANDS: A NATIONAL SURVEY

Abstract

Abstract Aim The incidence of a parastomal hernia (PSH) is approximately 40% two years after stoma construction and can even increase to 50% after a longer period. The European Hernia Society (EHS) published a guideline showing that the evidence for treatment of a PSH is of low quality. Due to the lack of evidence, a survey was conducted to provide insight into the Dutch approach. Material and Methods A survey was sent to 104 surgeons in the Netherlands representing their surgical department. The survey was developed by three hernia surgeons and a physiotherapist specialized in abdominal wall pathology. Results The survey was completed by 103 surgeons (99%) from 75 hospitals. 75% of the respondents perform a laparoscopic Sugarbaker for the treatment of PSH after colostomy, ileostomy or Bricker deviation. Most respondents (75%) replied that they never use a prophylactic mesh to prevent for the occurrence of PSH, although more than half of them do wish to introduce this. Conclusions Authors believe that the implementation of minimally invasive surgery and the systematic review performed by Hansson et al. in 2012, shifted the treatment strategy for PSH towards the use of a laparoscopic Sugarbaker. Nevertheless, little is known about the results of this treatment. Although there is a high level of evidence for the use of prophylactic mesh placement in reducing the incidence of PSH development, this has not been implemented in daily practice for colorectal and/or hernia surgeons. Authors aim for registration of PSH repair to evaluate the outcomes in terms of recurrence, pain and quality of life.