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Multicenter Study
. 2023 Aug 29;408(1):344.
doi: 10.1007/s00423-023-03062-5.

Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A french multi-institutional experience

Nicolas Bel  1 , Pierre-Yves Blanc  2 , David Moszkowicz  3 , Bradford Kim  4 , Pablo Ortega Deballon  2 , Delia Berrada  5 , David Liu  6 , Benoit Romain  6 , Delchet Ophélie  7 , Yohann Renard  8 , Guillaume Passot  9 ; SFCP-CH
Collaborators, Affiliations
Multicenter Study

Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A french multi-institutional experience

Nicolas Bel et al. Langenbecks Arch Surg. .

Abstract

Background: Parastomal incisional hernia (PH) is a frequent complication following the creation of an ileal conduit (IC), and it can be a significant detriment to quality of life. The aim of this study was to evaluate outcomes of PH repair following IC for urinary diversion.

Method: A multicenter retrospective study was conducted of 6 academic hospitals in France. The study's population included patients who underwent surgical treatment for parastomal hernia following IC creation from 2013 to 2021.

Results: Fifty-one patients were included in the study. Median follow up was 15.3 months. Eighteen patients presented with a recurrence (35%), with a median time to recurrence of 11.1 months. The vast majority of PH repair was performed through an open approach (88%). With regard to technique, Keyhole was the most reported technique (46%) followed by Sugarbaker (22%) and suture only (20%). The Keyhole technique was associated with a higher risk of recurrence compared to the Sugarbaker technique (52% vs 10%, p = 0.046). Overall, there was a 7.8% rate of major complications without a statistical difference between PH repair techniques for major complications.

Conclusion: Surgical treatment of parastomal hernia following IC was associated with a high risk of recurrence. Novel surgical approaches to PH repair should be considered.

Keywords: Abdominal wall hernia; Bricker; Keyhole; Sugarbaker.

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References

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