The clinical applications of D-type parastomal hernia repair surgery

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 28; no. 2; pp. 427 - 434
• Main Authors: Fu, Y. Y., Ma, Y., Zhang, C. K., Sun, L. H., Tang, D., Wang, W., Wang, D. R.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.04.2024; Springer Nature B.V
• Subjects: Abdominal Surgery; Abdominal wall; Colostomy - adverse effects; Colostomy - methods; Complications; Hernia; Hernia, Ventral - etiology; Hernia, Ventral - surgery; Hernias; Herniorrhaphy - methods; Humans; Incisional Hernia - complications; Incisional Hernia - surgery; Intestine; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Medicine; Medicine & Public Health; Original Article; Ostomy; Patients; Postoperative; Retrospective Studies; Statistical analysis; Surgery; Surgical Mesh - adverse effects; Surgical Stomas - adverse effects; Hernia repair; Stoma reconstruction; D-type modification; Lateral hernia; Function and appearance
• ISSN: 1248-9204; 1265-4906; 1248-9204
• DOI: 10.1007/s10029-023-02924-7

Objective This study investigated the use of a modified laparoscopic repair of paraostomy hernia technique, called “D-Type parastomal hernia repair surgery” which combines abdominal wall and extraperitoneal stoma reconstruction, in patients with parastomal hernia (PSH) following colorectal stoma surgery. The aim was to determine whether D-type parastomal hernia repair surgery is a promising surgical approach compared to the traditional laparoscopic repair technique (Sugarbaker method) for patients with PSH. Methods PSH patients were selected and retrospectively divided into two groups: the study group underwent D-type parastomal hernia repair, while the control group underwent laparoscopic Sugarbaker repair. Clinical data from both groups were analyzed. Result Compared to control group ( n  = 68), the study group undergoing D-type stoma lateral hernia repair had significant increase in total operative time (98.82 ± 12.37 min vs 124.61 ± 34.99 min, p  < 0.001). The study group also showed better postoperative stoma bowel function scores in sensory ability, frequency of bowel movements, and clothing cleanliness without a stoma bag ( p  = 0.037, 0.001, 0.002). The treatment cost was significantly higher in the control group (3899.97 ± 260.00$ vs 3215.91 ± 230.03$, p  < 0.001). The postoperative recurrence rate in the control group was 26.4%, while in the study group, it was 4.3%, with a significant statistical difference ( p  = 0.024). In terms of long-term postoperative complications, the study group had an overall lower incidence compared to the control group ( p  = 0.035). Other parameters showed no significant differences between the two groups. Conclusion The study suggests that D-type parastomal hernia repair surgery is a safe and feasible procedure. Compared to traditional surgery, it can reduce the recurrence of lateral hernia, improve postoperative stoma bowel function, and save medical resources.