Parastomal hernia repair using the lateral approach.
OBJECTIVE
To review the results of repairing a parastomal hernia after ileal conduit formation, using the lateral approach.


METHODS
We retrospectively assessed 18 patients (9%) who developed a parastomal hernia, from 211 who had an ileal conduit created between 1982 and 2001; 15 had a surgical repair using a lateral incision.


RESULTS
All 15 patients resumed a normal diet 1 day after surgery; the median (range) hospital stay was 4 (2-14) days. In two patients with a large hernia and difficult repair the stomas became ischaemic and required refashioning. Only one of these two patients required complete conduit replacement. The median (range) follow-up was 15 (1-72) months. A recurrence of the hernia was recorded in one grossly overweight patient.


CONCLUSIONS
The lateral approach obviates the need for laparotomy and stomal relocation, and enhances a quick return of bowel function and early recovery. However, extra care is needed in managing the very large and difficult hernia, to avoid compromising the ileal conduit. The success and complication rates of the current series are within acceptable limits and this technique can be included in the options for managing parastomal hernia.
The Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, UK. lmh0232@yahoo.com.hk
Kossen M T
KM
Ho
Derek P
DP
Fawcett
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D054047:Surgical Stomas; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery; D014547:Urinary Diversion