Sandwich parastomal hernia repair, a prospective observational study

Abstract

Purpose: The aim of the study is to evaluate the safety, feasibility and short and long term outcomes following the Sandwich repair for parastomal hernia.

Methods: A prospective single center study including all patients operated with Sandwich repair at St. Olav hospital, Trondheim University hospital from 2018 to 2023.

Results: Fifty four patients were treated with the Sandwich repair. All procedures were performed laparoscopically, with two conversions to open surgery due to adhesions. The median age was 67 years. 44% of the patients were females. Two thirds of the patients had a colostomy. Pain or discomfort was the most frequent indication for parastomal hernia repair, followed by leakage. Median operation time was 149 min. Eight patients were operated in an emergency setting. Six patients had a recurrence after previous surgery for parastomal hernia. Three patients had ClavienDindo complication rate 3b following the Sandwich repair and had their implants removed a few days after index surgery. The median in-hospital time was 5 (2-35) days and the median followup was 33 months (1-61). No recurrences were identified.

Conclusion: The laparoscopic Sandwich repair is a safe methode for most of the parastomal hernia patients. Even with a reasonable long median follow-up, we did not observe any recurrences.

Keywords: Hernia; Ostomy; Parastomal hernia; Recurrence; Treatment.