Parastomal hernia: complications of extra-peritoneal onlay mesh placement

To determine the complication and infection risks following extra-peritoneal onlay mesh placement in parastomal hernia repair.

A retrospective analysis of medical records was performed.

Parastomal hernia is a frequent complication of enterostomata. Fascial repair using a prosthetic mesh has been generally accepted as the best method of parastomal hernia repair. New studies suggest the use of a prophylactic mesh placement at the initial operation, but fear of wound infection and mesh removal is still high.

A retrospective review of patient records was performed of all patients with extra-peritoneal parastomal hernia repair using a prosthetic mesh between 1997 and 2006. The patient demographic data, enterostomy indication, therapy, and outcome were recorded.

In the 10-year study period, 16 parastomal hernia repairs using an extra-peritoneal prosthetic mesh in the onlay position were performed. In one patient, a mesh infection occurred, resulting in mesh removal (6.2%). The recurrence rate was 19% after a mean follow-up of 33 months.

Parastomal hernia repair using a prosthetic mesh is a safe and effective method, with the lowest recurrence rates and acceptably low infection rates. Prosthetic materials should not be used in cases of fecal contamination.