Role of biological mesh in surgical treatment of paracolostomy hernias.
BACKGROUND
Paracolostomy hernia is a frequent complication of intestinal stoma. Its correction can be made through relocation of the colostomy or by keeping it in place and performing abdominal wall reinforcement through direct suturing with or without a prosthesis.


METHODS
Results of surgical treatment of paracolostomy hernias were analyzed in 22 patients who underwent surgery in our hospital during the past 15 years, with or without biological mesh (bovine pericardium). All patients had terminal colostomies after abdominoperineal excision of the rectum.


RESULTS
In 15 (68.2%) patients, hernia correction was made by maintaining the colostomy in place, in 2 of them (9.1%) without reinforcement, and in the other 13 (59.1%) through reinforcement of the aponeurosis with biological mesh. In the 7 (31.8%) other patients, hernia correction was accomplished by relocation of the colostomy. The mean follow-up period was 50.2 months. Recurrence was observed in 3 (13.6%) patients after a median of 16 months post-correction.


CONCLUSIONS
Paracolostomy hernia remains a surgical challenge due to its high recurrence rate. Primary repair using a prosthesis of biological material may be preferable since muscle-aponeurotic weakness is frequently observed.
Araujo
Sergio Eduardo Alonso
SE
Department of Gastroenterology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. sergioed@terra.com.br
Habr-Gama
Angelita
A
Teixeira
Magaly Gêmio
MG
Caravatto
Pedro Paulo de Paris
PP
Kiss
Desidério Roberto
DR
Gama-Rodrigues
Joaquim
J
D001705:Bioprosthesis; D003125:Colostomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D054047:Surgical Stomas / Q000009:adverse effects*; D016896:Treatment Outcome