[Parastomal hernia repair and prevention with PHSL type mesh after abdomino-perineal rectum extirpation]

The parastomal hernia is a continuing challenge, because of the disappointing results of the different procedures available to repair it. The mesh implantation seems to be the best, but not optimal method with 8-22 % recurrence rate and about 15-20% other complications. The PHSL (Polypropylene hernia system large; Ethicon inc. Johnson and Johnson, USA) device proved to be an acceptable solution in correction the medium and large parastomal hernia with low recurrence and complication rate. The device enforces the abdominal wall with double mesh layer connected with a tube. The sigmoid colostomy is lifted trough the tube to the abdominal surface. The device was implanted with preventive intent in 14 cases, without any parastomal hernia formation in the first postoperative year. The preventive PHSL mesh implantation at the Miles operation seems to be an useful method for prevention of parastomal hernias.