Laparoscopic repair of parastomal hernias: a multi-centre retrospective review and shift in technique.
OBJECTIVE
To describe the reasons for a shift in our technique of laparoscopic repair of parastomal hernias towards repair with a non-slit mesh. Our initial results with repair using meshes with a keyhole had high recurrence rates.


METHODS
We performed a multi-centre retrospective study focusing on complications and recurrences. Data were gathered retrospectively from the medical records. The last follow-up date was the latest clinical examination by the surgeon. Recurrences were diagnosed clinically or by CT scan performed for oncological follow-up in cancer patients.


RESULTS
From September 2001 till May 2007, twenty-four patients with a symptomatic parastomal hernia were treated laparoscopically. No major intra- or postoperative complications were encountered. We had no conversions, no enterotomies and the overall postoperative morbidity was 8.4% (2/24). During a mean follow-up of 21.2 months, ten recurrences or 41.7% (10/24) have been diagnosed. In patients treated with a "keyhole technique" recurrence rate was 72.7% (8/11) with a mean follow-up of 30.7 months. In patients treated with a "modified Sugarbaker technique" recurrence rate was 15.4% (2/13) with a mean follow-up of 14.0 months.


CONCLUSIONS
We found laparoscopic parastomal hernia repair could be performed with few complications. We abandoned the "keyhole techniques" because of a high recurrence rate. We currently use a "modified Sugarbaker technique" with promising early results.
Muysoms
E E
EE
Department of Surgery, AZ Maria Middelares, Gent, Belgium. filip.muysoms@azmmsj.be
Hauters
Ph J
PJ
Van Nieuwenhove
Y
Y
Huten
N
N
Claeys
D A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery; D003125:Colostomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D013526:Surgical Mesh; D054047:Surgical Stomas / Q000009:adverse effects*; D016896:Treatment Outcome