title: Laparoscopic parastomal hernia repair: No different than a laparoscopic ventral hernia repair?
abstract: BACKGROUND
  Parastomal hernia (PH) is a common complication when a stoma is used. The high incidence (35-50%) and patient longevity have created a situation where patients are being referred for consideration of repair with more frequency. Due to the presence of an ostomy and the increased bacterial contamination of the area, the insertion of a prosthetic material is concerning for complications. Laparoscopic repair of parastomal hernias utilizing a modified Sugarbaker technique has been demonstrated to have excellent outcomes. The purpose of this study is to demonstrate that laparoscopic PH repair has outcomes similar to laparoscopic ventral hernia (LVH) repair without the presence of a stoma.
  
  
  METHODS
  After obtaining institutional review board approval, patients with parastomal hernia who underwent laparoscopic repair using Sugarbaker technique between 2009 and 2012 were compared to patients with ventral hernias who underwent LVH repair in a retrospective review, with a match of 1:3. Data collected included demographics, comorbidities, operative time, defect size, and mesh size. Outcomes and complications were compared between the two groups.
  
  
  RESULTS
  Twenty patients underwent Sugarbaker repair, and these cases were compared to 60 patients with ventral hernia that received LVH repair. There was no statistically significant difference in age, BMI, smoking status, ASA score, defect size, or mesh size between groups. Operative time was significantly longer in the PH group: 172 ± 35 versus the LVH group: 94 ± 32 min (p < 0.1). Length of stay was longer, 3 days (3-5.5) for PH versus 1 day (1-2.8) for LVH, p < 0.1. The two groups did not differ in terms of wound complications or recurrence, with a median follow-up of 37 days (IQ range 27-518).
  
  
  CONCLUSIONS
  The Sugarbaker technique is as safe as LVH repair with no more complications given the presence of a stoma.
authors.affiliation: Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, UKMC C-222, Lexington, KY, 40536-0298, USA.
authors.forename: Salomon
authors.initials: S
authors.lastname: Levy
authors.affiliation: Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, UKMC C-222, Lexington, KY, 40536-0298, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Plymale
authors.affiliation: University of Kentucky, Lexington, KY, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Miller
authors.affiliation: Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, UKMC C-222, Lexington, KY, 40536-0298, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Davenport
authors.affiliation: Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, UKMC C-222, Lexington, KY, 40536-0298, USA. jsroth2@uky.edu.
authors.forename: John Scott
authors.initials: JS
authors.lastname: Roth
mesh_terms: D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D054047:Surgical Stomas / Q000009:adverse effects*
keywords: Hernia repair; Laparoscopic repair; Parastomal hernia; Stoma