Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;23(8):2137-2145.
doi: 10.1111/codi.15729. Epub 2021 Jun 12.

High recurrence rate after posterior component separation and keyhole mesh reconstruction for complex parastomal hernia: A case series study

Alvaro Robin Valle de Lersundi  1 , Niccolo Rupealta  1 , Carlos San Miguel Mendez  1 , Joaquin Muñoz Rodriguez  1 , Marina Pérez Flecha  1 , Javier López Monclús  2 , Luis Blazquez Hernando  3 , Miguel Angel García Ureña  1
Affiliations

High recurrence rate after posterior component separation and keyhole mesh reconstruction for complex parastomal hernia: A case series study

Alvaro Robin Valle de Lersundi et al. Colorectal Dis. 2021 Aug.

Abstract

Aim: This study aimed to describe the results of complex parastomal hernia repair after posterior component separation and keyhole reconstruction.

Method: We conducted a retrospective review of a prospectively sustained database in one single complex abdominal wall referral centre. We analysed the data of patients who underwent the posterior component separation technique using modified transversus abdominis release for complex parastomal hernia and retromuscular keyhole mesh repair from February 2014 to January 2017. Demographic data, hernia characteristics, operative details and outcomes were analysed. The primary outcome measured was the recurrence rate during the follow-up.

Results: Twenty patients were included in this study. Among the patients who underwent surgery for parastomal hernia, 17 patients had a colostomy (85%) and three patients had a ureteroileostomy after the Bricker procedure (15%). The mean body mass index was 33.2 kg/m2 (range 25-47). Twelve patients had an expected associated risk according to the Carolinas equation for determining associated risk classification of >60%. Sixty per cent of our patients had contaminated or dirty/infected wounds. The overall complication rate was 60%. Surgical site infection was observed in 25% of the cases. The mortality rate in our study group was 5% (n = 1). We found clinical or radiological evidence of parastomal hernia recurrence in nine out of 20 (45%) patients during follow-up. No hernia recurrence was detected in the concomitant incisional hernias.

Conclusions: Although posterior component separation in the form of modified transversus abdominis muscle release allows abdominal wall reconstruction, keyhole mesh configuration at the stoma site does not offer satisfactory results in terms of long-term recurrence rate at the parastomal defect.

Keywords: Posterior components separation; complex para-stomal hernia; key-hole mesh repair; transversus abdominis release.

PubMed Disclaimer

References

REFERENCES

    1. Londono-Schimmer EE, Leong AP, Phillips RK. Life table analysis of stomal complications following colostomy. Dis Colon Rectum. 1994;37(9):916-20.
    1. Hansson BME, Slater NJ, van der Velden AS, Groenewoud HM, Buyne OR, de Hingh IH, et al. Surgical techniques for parastomal hernia repair. A systematic review of the literature. Ann Surg. 2012;255(4):685-95.
    1. Sheetz KH, Waits SA, Krell RW, Morris AM, Englesbe MJ, Mullard A, et al. Complication rates of ostomy surgery are high and vary significantly between hospitals. Dis Colon Rectum. 2014;57(5):632-7.
    1. van Dijk SM, Timmermans L, Deerenberg EB, Lamme B, Kleinrensink GJ, Jeekel J, et al. Parastomal hernia: impact on quality of life? World J Surg. 2015;39(10):2595-601.
    1. Ripoche J, Basurko F-P, Prudhomme M. Parastomal hernia. A study of the French federation of ostomy patients. J Visc Surg. 2011;148(6):435-41.

LinkOut - more resources