scholarly journals Keyhole versus Sugarbaker techniques in parastomal hernia repair following ileal conduit urinary diversion: a retrospective nationwide cohort study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisa Mäkäräinen-Uhlbäck ◽  
Jaana Vironen ◽  
Markku Vaarala ◽  
Pia Nordström ◽  
Anu Välikoski ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hernia Repair ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Parastomal Hernia ◽  
Ileal Conduit ◽  
Hernia Recurrence ◽  
Complication Rates ◽  
Parastomal Hernia Repair

Abstract Background Previous research on parastomal hernia repair following ileal conduit urinary diversion is limited. This nationwide cohort study aims to present the results of keyhole and Sugarbaker techniques in parastomal hernia repair in the setting of ileal conduit urinary diversion. Method All patients in this cohort underwent primary elective parastomal hernia repair following ileal conduit urinary diversion in four university hospitals and one central hospital in Finland in 2007–2017. Retrospective clinical data were collected from patient registries to compare keyhole and Sugarbaker parastomal hernia repair techniques. The primary outcome was parastomal hernia recurrence during the follow-up from primary surgery to the last confirmed follow-up date of the patient. The secondary outcomes were reoperations during the follow-up and complication rate at 30 days’ follow-up. Results The results of 28 hernioplasties were evaluated. The overall parastomal hernia recurrence rate was 18%, the re-operation rate was 14%, and the complication rate was 14% during the median follow-up time of 30 (21–64) months. Recurrence rates were 22% (4/18) after keyhole repair and 10% (1/10) after Sugarbaker repair. Re-operation rates referred to keyhole repair were 22% and Sugarbaker repair 0% during follow-up. The majority of reoperations were indicated by recurrence. Complication rates were 17% after keyhole and 10% after Sugarbaker repair during the 30 days’ follow-up. Conclusion The results of parastomal hernia repair in the setting of ileal conduits are below optimal in this nationwide cohort comparing keyhole to Sugarbaker repair in elective parastomal hernia repair. Nonetheless, the Sugarbaker technique should be further studied to confirm the encouraging results of this cohort in terms of recurrence.

scholarly journals Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up

2021 ◽  
Author(s):  
Elisa Mäkäräinen-Uhlbäck ◽  
Jaana Vironen ◽  
Ville Falenius ◽  
Pia Nordström ◽  
Anu Välikoski ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hernia Repair ◽  
Recurrence Rate ◽  
Parastomal Hernia ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Parastomal Hernia Repair ◽  
Operation Rate ◽  
Repair Techniques

Abstract Background Parastomal hernia repair is a complex surgical procedure with high recurrence and complication rates. This retrospective nationwide cohort study presents the results of different parastomal hernia repair techniques in Finland. Methods All patients who underwent a primary end ostomy parastomal hernia repair in the nine participating hospitals during 2007–2017 were included in the study. The primary outcome measure was recurrence rate. Secondary outcomes were complications and re-operation rate. Results In total, 235 primary elective parastomal hernia repairs were performed in five university hospitals and four central hospitals in Finland during 2007–2017. The major techniques used were the Sugarbaker (38.8%), keyhole (16.3%), and sandwich techniques (15.4%). In addition, a specific intra-abdominal keyhole technique with a funnel-shaped mesh was utilized in 8.3% of the techniques; other parastomal hernia repair techniques were used in 21.3% of the cases. The median follow-up time was 39.0 months (0–146, SD 35.3). The recurrence rates after the keyhole, Sugarbaker, sandwich, specific funnel-shaped mesh, and other techniques were 35.9%, 21.5%, 13.5%, 15%, and 35.3%, respectively. The overall re-operation rate was 20.4%, while complications occurred in 26.3% of patients. Conclusion The recurrence rate after parastomal hernia repair is unacceptable in this nationwide cohort study. As PSH repair volumes are low, further multinational, randomized controlled trials and hernia registry data are needed to improve the results.

scholarly journals Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study

2020 ◽  
Author(s):  
V. Holmdahl ◽  
U. Gunnarsson ◽  
K. Strigård
Keyword(s):  
Hernia Repair ◽  
Skin Graft ◽  
Parastomal Hernia ◽  
Complication Rates ◽  
Full Thickness ◽  
Full Thickness Skin Graft ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Parastomal Hernia Repair

Abstract Background Parastomal hernia is a common complication of stoma formation and the methods of repair available today are unsatisfactory with high recurrence and complication rates. To improve outcome after surgical repair of parastomal hernia, a surgical method using autologous full-thickness skin grafts as intraperitoneal reinforcement has been developed. The purpose of this study was to evaluate the feasibility of this novel surgical technique in the repair of parastomal hernia. Methods A pilot study was conducted between January 2018 and June 2019 on four patients with symptomatic parastomal hernia. They had a laparotomy with suture reduction of the hernia and reinforcement of the abdominal wall with autologous full-thickness skin. They were then monitored for at least 1 year postoperatively for technique-related complications and recurrence. Results No major technique-related complications were noted during the follow-up Two patients developed a recurrent parastomal hernia at the long term follow-up. The other two had no recurrence. Conclusions Autologous full-thickness skin graft as reinforcement in parastomal hernia repair is feasible and should be evaluated in a larger clinical trial.

1170 PARASTOMAL HERNIA REPAIR FOLLWING ILEAL CONDUIT URINARY DIVERSION USING A NOVEL FUNNEL MESH IMPLANT

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Christian von Bodman ◽  
Marko Brock ◽  
Florian Roghmann ◽  
Thilo Eggert ◽  
Jobst Pastor ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Urinary Diversion ◽  
Parastomal Hernia ◽  
Ileal Conduit ◽  
Parastomal Hernia Repair ◽  
Mesh Implant

scholarly journals OV18 ENDOSCOPIC RETRO-MUSCULAR REPAIR OF PARASTOMAL HERNIA - A TANTALIZING NEW TECHNIQUE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Jan Roland Lambrecht
Keyword(s):  
Hernia Repair ◽  
Parastomal Hernia ◽  
Abdominal Wall Hernia ◽  
Transversus Abdominis ◽  
Prophylactic Mesh ◽  
Parastomal Hernia Repair ◽  
Abdominal Wall Hernia Repair ◽  
Video Demonstration ◽  
Mesh Technique

Abstract Development of retro muscular space with transversus abdominis release has reached maturity in endoscopic surgery. Next-level reconstruction is adaptation to parastomal hernia repair alone or in conjunction with another abdominal wall hernia repair. We aim to present this extraperitoneal modified mesh technique based on the Sugarbaker principle with video demonstration and share clinical data and results from twenty-four patients operated with this technique within two years from the spring of 2019 to the spring of 2021. 77% patients had para-colostomy hernia and 41% of the patients had accessory repairs for midline or opposite flank hernia. 18% had prophylactic mesh at index operation, 27% were recurrent parastomal hernia and ostomies were formed median 32 months prior to parastomal hernia repair. 72% of the patients were operated robotically and 28% laparoscopically. Median follow up at time for presentation will be 17 months.

Ileal Conduit and Continent Ileocecal Pouch for Patients Undergoing Pelvic Exenteration: Comparison of Complications and Quality of Life

2011 ◽  
Vol 21 (2) ◽  
pp. 403-408 ◽  
Author(s):  
Dirk Michael Forner ◽  
Björn Lampe
Keyword(s):  
Quality Of Life ◽  
Urinary Diversion ◽  
Pelvic Exenteration ◽  
Ileal Conduit ◽  
Short Form ◽  
Complication Rates ◽  
Stomal Complications ◽  
Short Form Health

Objectives:Creating a continent urinary pouch has become an alternative to the ileal conduit for patients undergoing exenteration for advanced gynecologic malignancies. The objective of this study was to compare clinical outcomes for the 2 methods.Methods:In this retrospective study, we compared intraoperative and postoperative complications and quality-of-life scores for the modified ileocecal pouch and the ileal conduit in anterior or total pelvic exenteration.Results:In 33 of 100 patients, an ileal pouch (IP) was created; the other 67 were treated by an ileal conduit (IC). Creating an IP prolonged the exenterative procedure by 97 minutes compared to an IC (IC, 453 minutes vs IP, 550 minutes;P= 0.009). Overall complication rates were similar, but patients with an IP had significantly more complications of urinary diversion (48%) than patients with an IC (31%;P= 0.03). Follow-up showed urinary loss and frequency of micturition to be comparable, but in patients with an IP, surgery for stomal complications (n = 2) and treatment of bladderstones were necessary more frequently (n = 3). Quality of life according to the 12-item Short Form Health Survey questionnaire was similar in both groups.Conclusion:A continent IP is an alternative to the IC in cases of pelvic exenteration. Early complications are more frequent with an IP than with an IC. The mode of urinary diversion has little influence on the quality of life in patients with advanced genital cancer.

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