[Sugerbaker technique in para-colostomy hernia. An analysis of personal experiences]

Abstract

Paracolostomy hernias represent the most common complication after colostomy surgery occurring in approximately 30% of all patients. The need for operation, however, emerges in only 20% of the hernias becoming symptomatic with pain, difficulties in stoma care, bowel obstruction and cosmetic problems. Due to their often huge size the repair is technically difficult and frequently accompanied by complications and recurrence. The method of intraperitoneal mesh repair and lateralisation of the colon presented by Sugarbaker 1980 offers not only the advantages of sufficient strengthening of the ventral abdominal wall even in big hernias and of an aseptic technique but also the chance of simultaneous treatment of other hernias. We present 9 patients with large paracolostomy hernias operated on according to Sugarbaker. In three patients we delt with a recurrence of a paracolostomy hernia. Three patients suffered additionally from an incisional hernia, one from an umbilical hernia and another one from an inguinal hernia. The hernial orifice was usually closed with a 30 x 20 cm Gore patch. All patients (6 males, 3 females, median age 63 years) tolerated the operation well which lasted as a mean 240 min. In the follow-up we saw two recurrences one of them being small, asymptomatic and without tendency to enlargement. In conclusion we can say that a considerable improvement was achieved in 89% of our patients after surgery performed in the herein presented way. We esteem this method a good option in a situation with otherwise poor alternatives.