title: Role of biological mesh in surgical treatment of paracolostomy hernias.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. sergioed@terra.com.br
authors.forename: Sergio Eduardo Alonso
authors.initials: SE
authors.lastname: Araujo
authors.forename: Angelita
authors.initials: A
authors.lastname: Habr-Gama
authors.forename: Magaly Gêmio
authors.initials: MG
authors.lastname: Teixeira
authors.forename: Pedro Paulo de Paris
authors.initials: PP
authors.lastname: Caravatto
authors.forename: Desidério Roberto
authors.initials: DR
authors.lastname: Kiss
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gama-Rodrigues
mesh_terms: 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