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Laparoscopic parastomal hernia repair with modified Sugarbaker technique in patients after abdominoperineal resection of the rectum – initial experience


Authors: M. Škrovina 1,2;  J. Bartoš 1;  E. Holášková 1;  M. Migrová 1;  K. Klos 1;  P. Anděl 1
Authors place of work: Chirurgické oddělení, Nemocnice Nový Jičín, a. s., Komplexní onkologické centrum Nový Jičín primář: MUDr. M. Škrovina, Ph. D. 1;  1. chirurgická klinika, LF UP Olomouc, přednosta: prof. MUDr. Č. Neoral, CSc. 2
Published in the journal: Rozhl. Chir., 2014, roč. 93, č. 10, s. 502-506.
Category: Původní práce

Summary

Introduction:
Parastomal hernia is a common stoma complication. Surgical treatment is necessary in approximately 10 to 20% of cases. Mesh hernia repair gives significantly better results. The authors present their initial experience with laparoscopic repair of parastomal hernia using the modified Sugarbaker technique.

Material and methods:
In the period from January 2011 to December 2013, 15 patients with a symptomatic parastomal hernia underwent laparoscopic repair with modified Sugarbaker technique. All patients had a parastomal hernia at the site of terminal colostomy after abdominoperineal resection. 14 patients underwent primary hernia repair, 1 patient was operated on for recurrence of parastomal hernia after open hernia repair. Parietex™ Parastomal mesh was used for hernia repair in all cases.

Results:
Laparoscopic repair was performed successfully in all patients. The mean operating time was 45 minutes (range: 20−80 minutes). The mean postoperative hospital stay was 3 days (range: 2−6 days). No serious postoperative complication was recorded. In the postoperative period, a recurrent symptomatic hernia was found in 1 of 15 patients (6.7%) with reintervention 17 months after primary surgery.

Conclusion:
Laparoscopic hernia repair of parastomal hernia with modified Sugarbaker technique seems to be a safe method with a very low risk of postoperative complications, including hernia recurrence.

Key words:
terminal colostomy – parastomal hernia – laparoscopic repair – Sugarbaker technique


Zdroje

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Chirurgie všeobecná Ortopedie Urgentní medicína

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