Parastomal hernia repair: a single center experience

Abstract

Background/objectives: Despite multiple options for operative repair of parastomal hernia, results are frequently disappointing. We review our experience with parastomal hernia repair.

Methods: A retrospective chart review was performed on all patients with parastomal hernia who underwent LAP or open repair at our institution between 1999 and 2006. Information collected included demographics, indication for stoma creation, operative time, length of stay, postoperative complications, and recurrence.

Results: Twenty-five patients who underwent laparoscopic or open parastomal hernia repair were identified. Laparoscopic repair was attempted on 12 patients and successfully completed on 11. Thirteen patients underwent open repair. Operative time was 172+/-10.0 minutes for laparoscopic and 137+/-19.1 minutes for open cases (P=0.14). Lengths of stay were 3.1+/-0.4 days (laparoscopic) and 5.1+/-0.8 days (open), P=0.05. Immediate postoperative complications occurred in 4 laparoscopic patients (33.3%) and 2 open patients (15.4%), P=0.38. Parastomal hernia recurred in 4 laparoscopic patients (33.3%) and 7 open patients (53.8%) after 13.9+/-4.5 months and 21.4+/-4.3 months, respectively, P=0.43.

Conclusion: Laparoscopic modified Sugarbaker technique in the repair of parastomal hernia affords an alternative to open repair for treating parastomal hernia.

Figure 1.

Location of trocar placement for repair of left-sided PH (A) and for repair of right-sided PH (B).

Figure 2.

Colostomy (black arrow) with associated parastomal fascial defect (white arrow) following reduction of herniated bowel (A); Intact Gore-Tex Dual Mesh against anterior abdominal wall with underlying bowel limb (black, dashed line) obliquely exiting from mesh (white arrow) (B).