title: Parastomal hernia: complications of extra-peritoneal onlay mesh placement.
abstract: OBJECTIVE
  To determine the complication and infection risks following extra-peritoneal onlay mesh placement in parastomal hernia repair.
  
  
  METHODS
  A retrospective analysis of medical records was performed.
  
  
  BACKGROUND
  Parastomal hernia is a frequent complication of enterostomata. Fascial repair using a prosthetic mesh has been generally accepted as the best method of parastomal hernia repair. New studies suggest the use of a prophylactic mesh placement at the initial operation, but fear of wound infection and mesh removal is still high.
  
  
  METHODS
  A retrospective review of patient records was performed of all patients with extra-peritoneal parastomal hernia repair using a prosthetic mesh between 1997 and 2006. The patient demographic data, enterostomy indication, therapy, and outcome were recorded.
  
  
  RESULTS
  In the 10-year study period, 16 parastomal hernia repairs using an extra-peritoneal prosthetic mesh in the onlay position were performed. In one patient, a mesh infection occurred, resulting in mesh removal (6.2%). The recurrence rate was 19% after a mean follow-up of 33 months.
  
  
  CONCLUSIONS
  Parastomal hernia repair using a prosthetic mesh is a safe and effective method, with the lowest recurrence rates and acceptably low infection rates. Prosthetic materials should not be used in cases of fecal contamination.
authors.affiliation: Department of Surgery, Alysis Zorggroep, locatie Rijnstate, Arnhem, The Netherlands. T.luning@gmail.com
authors.forename: T H
authors.initials: TH
authors.lastname: Lüning
authors.forename: E-J
authors.initials: EJ
authors.lastname: Spillenaar-Bilgen