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[Para-stomal hernia--technique and results]
1II. Lehrstuhl für Chirurgie der Universität zu Köln, Städtisches Krankenhaus Köln-Merheim.
Zentralblatt Fur Chirurgie
|January 1, 1997
Summary
Parastomal hernias are common after stoma surgery. Mesh repair is the preferred treatment due to its low recurrence rate, unlike older methods.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Parastomal hernias are a frequent long-term complication following stoma creation.
- Surgical intervention is reserved for symptomatic cases, representing about 10% of all instances.
Purpose of the Study:
- To evaluate the efficacy of different surgical techniques for parastomal hernia repair.
- To determine the optimal treatment strategy for symptomatic parastomal hernias.
Main Methods:
- Review of surgical outcomes for local fascial repair versus prosthetic mesh repair.
- Analysis of recurrence and complication rates associated with stomal relocation and mesh repair techniques.
Main Results:
- Local fascial repair demonstrates a high recurrence rate of 80% and is no longer indicated.
- Stomal relocation leads to recurrent parastomal hernias in 40% of cases and incisional hernias in 20-30%.
- Prosthetic mesh repair shows a significantly lower recurrence rate of 8% with an acceptable 9% infection rate.
Conclusions:
- Prosthetic mesh repair is the current procedure of choice for treating parastomal hernias.
- Mesh repair offers superior outcomes compared to local fascial repair and stomal relocation.
- The low recurrence and acceptable infection rates support the widespread adoption of mesh repair.