Parastomal hernias as the predominant stoma complication after laparoscopic colorectal surgery

Many colorectal procedures can be performed laparoscopically and frequently involve the formation of a stoma. This study aims to demonstrate whether there is an association between stoma complications and the operative technique: laparoscopic or open. A review was conducted of all patients undergoing stoma formation at a single center throughout 2009. Forty-four had a stoma formed after an open procedure and 33 using laparoscopic technique alone. The most common stoma complication was parastomal hernias; these occurred after 18% of laparoscopic compared with 2% after open procedures (P = 0.04). The highest rate of parastomal hernia was seen when the resected specimen was removed from the site that was later used to create a stoma (60%). This study has suggested that the use of laparoscopic surgery may influence the rate of stoma complications. One potential method of reducing the incidence of parastomal hernias is to remove the resected specimen through a separate incision.