Surgical treatment of parastomal hernia complicating sigmoid colostomies

• Published in: Diseases of the colon & rectum Vol. 44; no. 2; pp. 266 - 270
• Main Authors: Cheung, Moon-Tong, Chia, Nam-Hung, Chiu, Wai-Yip
• Format: Journal Article
• Language: English
• Published: Secaucus, NJ The ASCRS 01.02.2001; Springer
• Subjects: Aged; Biological and medical sciences; Colon, Sigmoid - surgery; Colostomy; Female; Herniorrhaphy; Humans; Male; Medical sciences; Postoperative Complications - surgery; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Flaps; Surgical Mesh; Surgical Stomas; Tropical medicine; Asia; China; Hernia; Human; Pelvic colon; Treatment; Surgery; Digestive diseases; Intestinal disease; Complication; Colostomy
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/BF02234303

PURPOSE:Parastomal hernia is a common late complication of colostomy. Surgical approach to the repair of parastomal hernia is controversial. Results of surgical treatment are disappointing. The aim of this study was to assess the outcome of surgical treatment of parastomal hernia. METHOD:This article reports a retrospective review of those patients who had undergone a surgical treatment of parastomal hernia complicating sigmoid colostomy. The indications, surgical procedures, complications, and outcome were carefully studied. RESULTS:There were 43 surgical treatments of parastomal hernia. Sixteen underwent simple local repair; 25 stomas were relocated, and 2 were locally repaired with mesh. Overall recurrence was 18 of 40 (45 percent). Recurrences for fascial repair and stoma relocation were 6 of 13 (46 percent) and 10 of 25 (40 percent), respectively. Stoma relocation could be accomplished without formal laparotomy in 19 of 25 cases. Incisional hernia occurred in only 2 of these 25 relocations. CONCLUSION:Fascial repair alone can be performed for symptomatic small hernias because of its advantage of minimal morbidity. Stoma relocation without formal laparotomy can be advocated for larger hernias. A combination of local resite together with mesh reinforcement may be the alternative for further improvement of results.