Repair of parastomal hernia associated with incisional hernia and pendulous abdomen

ABSTRACT

Parastomal hernia [PSH] represents one of the difficult challenges for the surgeon. The association of incisional hernia [laparocele] and parastomal hernia adds to the novel of the issue especially if the abdomen is pendulous. The aim of this study is to evaluate a surgical treatment plan for such complex situations. Seventeen patients with parastomal hernia around a permanent stoma associated with laparocele and pendulous abdomen were selected for the study. They were 11 males and 6 female with a mean age of 53 +/- 9 years. After preoperative assessment, they were subjected to relocation of the stoma plus reinforcement of the laparocele repair and the old stoma site with onlay proparietal polypropylene mesh together with dermolipectomy. The overall complications were encountered in three patients Wound infection was reported in the 3 cases [17.7%], seroma in 2 [11.8%], minimal flap necrosis in 2 [11.8%] sinus formation in one patient [5.9%] and development of PSH at the new site in two patients 11.8%. The association of parastomal hernia, incisional hernia and pendulous abdomen jeopardizes the patient's quality of life and surgery is often indicated. The repair by relocation and reinforcement with onlay polyproplene mesh together with dermolipectomy represents a good solution in terms of low morbidity and an acceptable final outcome: