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Parastomal Hernia
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
James R.F. Hollingshead, Roger W. Motson
Both patient and technical factors contribute to the risk of parastomal hernia formation and as with other abdominal wall hernias the risks are increased in situations of impaired wound healing found in diabetes, malnutrition and steroid usage2; obesity and increasing age are additional independent risk factors.3
Stoma and Its Complications
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
It is a very common complication which can arise at any time after the creation of a stoma, ranging from weeks to years. Patients complain of a dragging sensation, which is usually painless and associated with a sudden increase in size and shape of the stomach. The risk factors associated are being overweight, postoperative complications, and heavy lifting. If a parastomal hernia is obstructed or associated with other complications, then surgical repair should considered.
Abdominal wall, hernia and umbilicus
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Recent reports (Millbourne et al.) have described the use of prophylactic mesh insertion at the time of formation of the stoma. A lightweight, polypropylene mesh is inserted in the retromuscular space so that the bowel passes through a hole in the mesh centre. Using this technique, parastomal hernia rates have been reduced significantly.
Urostomal ileal conduit complications in association with abdominal wall mesh implantation
Published in Scandinavian Journal of Urology, 2022
L. Jakobsson, A. Montgomery, J. Ingvar, A. Löfgren, F. Liedberg
An ileal conduit is the most common type of urinary diversion fashioned in conjunction with radical cystectomy (RC). The surgery is either carried out with robotic-assisted laparoscopy or through a lower midline incision. Similarly, during pelvic exenteration surgery, an ileal conduit is constructed in addition to an ostomy for the bowel diversion, the latter most commonly as an end sigmoidostomy. The cystectomy itself is associated with abdominal wall-related complications such as incisional hernias in up to 20% of the patients at follow-up [1,2]. In addition, stoma-related complications such as protrusion of abdominal content through a local defect in the abdominal wall at the site of the ileal conduit can occur, i.e. a parastomal hernia (PH) [3]. A PH does frequently cause an ill-fitting ostomy bandage, bowel and/or urinary obstruction, as well as considerable discomfort [4]. Similarly, after colorectal surgery, PHs frequently occur and many patients have some type of symptoms due to their PH [5]. Stoma site fascial incisions of >35mm, age >70 years, BMI >25, diabetes, and increased abdominal pressure are risk factors associated with the development of a PH [6].
Parastomal hernia after ileal conduit urinary diversion: re-visiting the predictors radiologically and according to patient-reported outcome measures
Published in Scandinavian Journal of Urology, 2020
Ahmed M. Harraz, Ahmed Elkarta, Mohamed H. Zahran, Amr A. Elsawy, Mohamed A. Elbaset, Ali Elsorougy, Yasser Osman, Ahmed Mosbah, Hassan Abol-Enein, Atallah A. Shaaban
Parastomal hernia is not an uncommon consequence following IC [13]. Most of the previous reports focused on the incidence and risk factors of developing PSH; nevertheless, the major drawback was that the different definitions of PSH were not consistent; for instance, clinical evaluation was used in some reports [5,13–15], while others used an image-based definition [3,9]. In a recent systematic review, the authors found that there was no standardized methodology for reporting. In addition, most of the studies were dependent on retrospectively reviewed data, and imaging was done primarily for detecting local recurrence or other complications [16]. In our study, we adopted the EHS classification [10] which is a validated tool that can be used for comparison between different centers. In addition, the relationship with PROM was explored as the mere definition of hernia does not usually reflect the patient's perception and complaint.
Perineal hernia mesh repair: a fixation with glue, sutures and tacks. How to do it
Published in Acta Chirurgica Belgica, 2019
L. Hassan, A. Beunis, M. Ruppert, V. Dhooghe, S. Van den Broeck, G. Hubens, N. Komen
This case describes a 51 years old man who was known with a rectal carcinoma. He had a rectumamputation and a colostoma. Also, a repair of the Bricker loop, a form of incontinent urostomy, was needed due to stenosis after radiotherapy. In that same year, he presented with a parastomal hernia at the level of the colostoma and a PH. After a median laparotomy, both the Bricker loop and the colostoma were divided from adjacent tissue. In the perineal cavity, the omentum was found to be very adhesive and was, therefore, totally dissected. Due to a stenosis underneath the fascia at the Bricker loop, it was decided that a second operation would be needed to repair the parastomal hernia. The laparotomy PH repair was done following the technique we described by placing a Dynamesh and fixating it with Ifabond® (Ifabond® laparoscopic glue, Péters Surgical, Bobigny, France).