scholarly journals OV02 COMPLEX PARASTOMAL HERNIA REPAIR WITH MESH FISTULA AND MESH INFECTION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Sharbel Elhage ◽  
Eva Deerenberg ◽  
Sullivan Ayuso ◽  
Vedra Augenstein ◽  
Kevin Kasten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Parastomal Hernia ◽  
Botulinum Toxin A ◽  
Operative Procedure ◽  
Mesh Infection ◽  
Loss Of Domain ◽  
Parastomal Hernia Repair ◽  
Mesh Excision

Abstract Aim Parastomal hernias of any size can be difficult to manage and greatly affect a patient’s quality of life, however, they can be even more problematic when associated with loss of domain and infection. The aim of our video was to demonstrate open repair of a massive parastomal hernia complicated by loss of domain, mesh fistula, and mesh infection. Material and Methods Images and footage from clinic and the operative procedure were included. Results A 51-year-old female with a history of prior APR followed by failed ventral and parastomal hernia repairs presented with a massive parastomal hernia that was significantly impacting her and her family’s quality of life. Due to her hernia, she had become immobile and was bed bound. Furthermore, the hernia had caused significant chronic constipation secondary to colonic dysmotility. The patient also had loss of domain, and her hernia appeared to be complicated by a chronic mesh infection with a draining sinus. She underwent pre-operative bilateral botulinum toxin A injection in the oblique abdominal musculature. She then underwent open preperitoneal parastomal hernia repair with biologic mesh, excision of prior mesh, primary fistula repair, total abdominal colectomy, and end ileostomy. The patient tolerated the procedure well without complications and has continued to do well in follow-up. She has had great improvement in her quality of life. Conclusions In this patient with a massive parastomal hernia complicated by loss of domain, mesh fistula, and mesh infection, we demonstrate a successful open preperitoneal repair following pre-operative BTA injection.

scholarly journals Comparing Sugarbaker versus keyhole mesh technique for open retromuscular parastomal hernia repair: study protocol for a registry-based randomized controlled trial

2022 ◽  
Author(s):  
Benjamin T Miller ◽  
Jonah D Thomas ◽  
Chao Tu ◽  
Adele Costanzo ◽  
Lucas A Beffa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Hernia Repair ◽  
Parastomal Hernia ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Parastomal Hernia Repair ◽  
Sugarbaker Technique ◽  
Mesh Technique

Abstract BackgroundParastomal hernia, common after stoma creation, negatively impacts patient quality of life. For patients with a permanent stoma, durable parastomal hernia repair remains a challenge, with few high-quality studies for guidance. An alternative to open retromuscular parastomal hernia repair with retromuscular “keyhole” mesh is the recent Sugarbaker modification. We aim to compare these two techniques in a head-to-head prospective study.MethodsThis is a registry-based randomized controlled trial designed to investigate whether the retromuscular Sugarbaker technique is superior to the retromuscular keyhole technique for parastomal hernia repair. The primary study endpoint is parastomal hernia recurrence at two years. Secondary endpoints include hospital length-of-stay, readmission, wound morbidity, mesh-related complications, re-operation, all 30-day morbidity, and patient-reported outcomes, including hernia-related quality of life, stoma-specific quality of life, pain, and decision regret.DiscussionBased on the post hoc analysis of a recent randomized controlled trial, we hypothesize that the retromuscular Sugarbaker technique will reduce parastomal hernia recurrence by 20% at 2 years compared to the retromuscular keyhole mesh technique. The results of this study may provide evidence-based guidance for surgeons repairing parastomal hernias.Trial registrationClinicalTrials.gov NCT03972553. Registered June 3, 2019.

Quality of life and parastomal hernia repair: the PROPHER study

Hernia ◽  
2020 ◽  
Vol 24 (2) ◽  
pp. 429-430
Author(s):  
S. Blackwell ◽  
T. Pinkney
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Parastomal Hernia ◽  
Parastomal Hernia Repair

scholarly journals Mesh Infection by Stomal Perforation after Recurrent Parastomal Hernia Repair Using the Keyhole Technique

2019 ◽  
Vol 52 (11) ◽  
pp. 679-686
Author(s):  
Itaru Hashimoto ◽  
Hitoshi Murakami ◽  
Daisuke Inagaki ◽  
Michio Ueda ◽  
Tomohiko Osaragi ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Parastomal Hernia ◽  
Mesh Infection ◽  
Parastomal Hernia Repair

scholarly journals Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
M. M. J. Van Rooijen ◽  
T. Tollens ◽  
L. N. Jørgensen ◽  
T. S. de Vries Reilingh ◽  
G. Piessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
Recurrence Rates ◽  
Elective Repair ◽  
Significant Difference ◽  
Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

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