Repair Methods in Parastomal Hernia Surgery

Abstract

Background-Aim: Parastomal hernias (PSH) are incisional hernias that must be classified separately from the other abdominal wall hernias. The high recurrence rate of PSH is the most important problem after suture repair or relocation of the stoma; whereas open or laparoscopic mesh repair results in much lower recurrence rates. The aim of this study is to investigate PSH predisposing factors, surgical repair methods, postoperative complications and recurrence in surgery practice.
 Methods: Patient demographics, operation time before the first surgery, operation method, and the recurrence rate seen in patients who underwent PSH surgery in a 10-year time/ period (2008-2018) were investigated from the patient records. Except for emergency cases, 2 years of disease-free time was set for PSH surgery in malignant cases to be sure that no malignancy was present in the time of operation. 
 Results: 14 PSHs were treated surgically using mesh repair in all cases. There were 6 male and 8 female patients with a mean age of 71.7 years (range:45-84;median:78). Open sublay polypropylene mesh placement technique was performed in 12 patients and intraperitoneal composite mesh (using either keyhole or Sugarbaker techniques) was placed laparoscopically in 2 patients. Superficial wound infections were developed in 4 patients (28.5 %) and 2 patients developed recurrence (14.2%).
 Conclusion: There is no effective method defined for the surgery of PSH but the laparoscopic approach has been proposed as a promising alternative to open technique as it causes less abdominal wall trauma. Whether performed open or laparoscopic; mesh repair is the optimal standard for PSH surgery.