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Related Experiment Videos

[Update on incisional hernia. Parastomal hernia].

R Kasperk1, S Willis, U Klinge

  • 1Chirurgische Klinik und Poliklinik Universitätsklinikum der RWTH Aachen, Germany. chirurgie@katholisches-klinikum.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|September 26, 2002
PubMed
Summary

Parastomal herniation, a common complication of artificial anus construction, often requires surgical repair. Abdominal wall reinforcement with mesh significantly reduces recurrence rates compared to older methods.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Wall Surgery

Background:

  • Parastomal herniation frequently complicates the creation of an artificial anus (stoma).
  • The non-physiological nature of abdominal wall tunnels predisposes stomas to aperture enlargement and herniation.
  • Previous technical modifications have failed to reliably decrease parastomal herniation incidence.

Purpose of the Study:

  • To evaluate the efficacy of different surgical repair methods for parastomal herniation.
  • To identify the most effective technique for minimizing recurrence rates.

Main Methods:

  • Review of surgical repair techniques for parastomal herniation.
  • Comparison of recurrence rates for fascial closure, stoma relocation, and mesh augmentation.

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  • Analysis of outcomes based on combined and isolated application of techniques.

    • Main Results:

    • Fascial closure and stoma relocation exhibit high recurrence rates (40%-80%) when used alone.
    • Abdominal wall reinforcement using nonabsorbable meshes achieves recurrence rates below 20%.
    • Optimal mesh type and implantation technique remain subjects of ongoing research.

    Conclusions:

    • Isolated fascial closure and stoma relocation are no longer recommended for parastomal hernia repair.
    • Mesh augmentation of the abdominal wall is the most effective method for reducing parastomal hernia recurrence.
    • Further investigation is needed to determine the best mesh materials and surgical techniques.