Background
Materials and methods
Results
Author | Year | Study design | No. of colostomies | Indication for initial stoma creation | Surgery technique | Stoma type | Recurrent PSH | Type of mesh | Mesh position | Complications | Mean follow-up (months) | Recurrences | Results |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Laparoscopic approach | |||||||||||||
A. Asif [6] | 2012 | Retrospective study | 16 | IBD (30), Cancer (9), Diverticulitis (5), Other (5) | Laparoscopic modified Sugarbaker (14), laparoscopic Keyhole (19), ostomy re-sitings (11), open primary repair (5) | Ileostomy (33) colostomy (16) | 19 | Gore Dual-Mesh® | Intraperitoneal | Ileus (11), wound infection (6), small bowel obstruction (1), pneumonia (1) | 7.5–35.8 | 19 | The modified SB technique may offer patients a significant decrease in the risk of recurrence compared with other PH repair techniques with no significant increase in postoperative complication |
B. M. E. Hansson [31] | 2012 | Retrospective multicenter study | 55 | Colorectal and anal malignancy (43); bladder carcinoma (2); IBD 86); diverticulitis (6); incontinence (3); benign rectal stenosis (1) | Laparoscopic modified Sugarbaker technique | Colostomy (55), ileostomy (4), urostomy (2) | 11 | Gore-Tex Dual-Mesh Biomaterial® | Intraperitoneal | Wound infection (1), postoperative ileus (6), trocar site bleeding (2), mesh infection (1), pneumonia(1), seroma (12) | 26 | 4 | Laparoscopic parastomal hernia repair using the Sugarbaker technique with an ePTFE mesh is safe, with recurrence rate of 6.6%. A laparoscopic approach revealed a concomitant incisional hernia in 41% of the patients, which was repaired at the same time |
F. J. DeAsis [23] | 2015 | Retrospective study | 23 | Unspecified | Laparoscopic modified Sugarbaker (25), Keyhole (18), stoma relocation (13), open repairs (6) | Colostomy (23), ileostomy (39) | 23 | Gore Dual-Mesh® | Intraperitoneal | Hemorrhage (Sugarbaker 1, Keyhole 1, open repairs 1), ileus (Sugarbaker 4, Keyhole 9, Re-siting 3, open repairs 1), mesh infection (Sugarbaker 1), wound infection (Sugarbaker 2, Keyhole 3, Re-siting 2, open repairs 1), small bowel obstruction(Keyhole 2), urinary tract infection (Sugarbaker 1) | Sugarbaker 16.6, Keyhole 19.6, re-siting 16.4, open repairs 27.2 | 4 (Sugarbaker), 11 (Keyhole), 9 (Re-siting), 2 (open) | A laparoscopic modified SB technique provides decreased rates of recurrence and postoperative complications compared with other approaches |
G. Kohler [48] | 2015 | Retrospective study | 120 | Oncological (117), non malignant disease (18) | Fascial sutures (25), Onlay mesh (22), Sublay mesh (20), Laparoscopic keyhole (22), Laparoscopic Sugarbaker (4), Laparoscopic sandwich (21), Laparoscopic same-side stoma relocation through funnel mesh (16), Open same-side stoma relocation through funnel mesh (5) | Colostomy (120), Ileostomy (10), Urostomy (5) | 31 | Vypro or Vypro II, Ultrapro, Parietene,parietex composite, DynaMesh-IPOM, DynaMesh-IPST | Onlay, sublay, and intraperitoneal methods | Bowel injurie (2 laparoscopic), mesh infections (2 open), surgical site infections (8), subcutaneous seromas (2) | 54 | 44 | The results achieved by direct suture or the use of incised flat meshes for the repair of PSH were poor with these procedures having unacceptably high recurrence rates. With regard to the latter ostomy revision through three-dimensional funnel-shaped meshes and the laparoscopic sandwich technique showed the best results. Emergency procedures were linked to a dramatic increase in morbidity and mortality |
M. Szczepkowski [28] | 2015 | Prospective single surgeon study | 12 | Colorectal cancer (9), prostate cancer (1), rectal prolapse (1) rectovaginal fistula (1) | HyPER/SPHR technique (hybrid parastomal endoscopic re-do/Szczepkowski parastomal hernia repair) | Colostomy (12) | 0 | DynaMesh-IPST® | Intraperitoneal | No stoma site infection (SSI) or stoma-related problems were found | 13.5 | 0 | Early results show that is has a high patient satisfaction rate and a low number of complications. This novel approach seems to be very promising in terms of the complication rate and recurrence rate |
K. Suwa [49] | 2016 | Retrospective study | 16 | Rectal cancer (7), Bladder cancer (3), Perforation of sigmoid colon (3), Colon cancer (1), Fournier’s gangrene (1), Perineal Paget’s disease (1) | Laparoscopic modified Sugarbaker | Colostomy (13), ileal conduit (3) | 2 | Parietex™ Parastomal Mesh (PCO-PM) | Intraperitoneal | Ureteral obstruction (1), enterotomy intraoperative (1) | 14.5 | 0 | Sugarbaker’s modified laparoscopic approach to parastomal hernia repair, using the PCO-PM technique, was found to be safe and effective, with no recurrences observed during the average follow-up of 14.5 months and with a low incidence of complications |
I. Fischer [27] | 2017 | Retrospective analysis | 47 | Unspecified | 3D funnel mesh in IPOM technique | Colostomy (47) Ileostomy (2) Urostomy (7) | 17 | DynaMesh-IPST® | Intraperitoneal | Local infections and seroma (4), stoma necrosis (1), stoma retraction (1), bleeding (1), ileus (1), iatrogenic bowel lesion (1) | 38 | 4 (open), 3 (laparoscopic) | Long-term clinical follow-up with standardly integrated CT scan, we did not detect any severe mesh-related complications |
G. Kohler [38] | 2017 | Pilot prospective case series | 10 | Oncological (12) | Combined laparoscopic and ostomy-opening approach | Colostomy (10), ileostomy (1), urostomy (1) | Unspecified | DynaMesh-IPST | Intraperitoneal | Superficial peristomal wound defect (1) | 36 | 12% | The technique described gives several advantages, such as a minimally invasive hybrid approach creating a real three-dimensional mesh-covered barrier between the trephine and stomal limb and optional shortening of a concomitant prolapse. When needed due to a concomitant incisional hernia, a second flat mesh can be laparoscopically placed in an intraperitoneal position |
E. Oma [12] | 2018 | Retrospective study | 79 | Colonic malignancy (2), rectal malignancy (41) Anal malignancy (1), Diverticular disease (3), anal fistula (3), IBD (16), adhesive small bowel obstruction (1), obstructed defecation (4), fecal incontinence (7), congenital anomaly (1) | Keyhole (10), Sugarbaker (69) | 60 colostomy, 19 ileostomy | 5 | Parietex™ Composite Parastomal Mesh | Intraperitoneal | Obstruction due to mesh (3), Abscess (1), Adhesions (1), Subcutaneous prolapse (20), Chronic pain (3) | 12 | 1 (keyhole), 6 (Sugarbaker) | This study demonstrated that this mesh material was an excellent choice for parastomal hernia repair performed by experienced surgeons and found low rates of recurrence and chronic pain following parastomal hernia repair using intra- peritoneal reinforcement with a polyester monofilament composite mesh |
S. Rege [34] | 2018 | Retrospective study | 12 | Carcinoma rectum (12), IBD (1), carcinoma urinary bladder (1) | Modified Sugarbaker | Colostomy (12), ileostomy (1), ileal conduit (1) | Unspecified | Parietex Composite Mesh | Intraperitoneal | No complications as recurrence, seroma, mesh infections or erosions into the stoma | 15–85 | 0 | Laparoscopic repair of parastomal hernias with modified mesh placement in the Sugarbaker technique could help reduce mesh-related complications, thereby reducing the risk of hernia recurrence, in addition to the advantages of minimally accessible surgery |
Z. Yan [10] | 2018 | Retrospective study | 60 | Colorectal and anal malignancy (60), IBD (4), Bladder carcinoma (1) | Modified laparoscopic keyhole parastomal hernia repair with in situ re-ostomy | Ileostomy (4), Colostomy (60), Urostomy (1) | 2 | Sepramesh™ IP Composite prosthesis or Parietex®composite mesh | Intraperitoneal | Seroma (2), ileus (3), intestinal perforation (1) | 29 ± 2.1 | 1 | White this technique, patients not only receive the benefits of minimally invasive surgery but also suffer less abdominal trauma, without an extra incision. The recurrence rate was lower than that of other techniques during the follow-up period |
S. Olmi [29] | 2019 | Retrospective study | 90 | Rectum cancer (40), Colon-rectum cancer (21), Rectum injury (5), IBD (15), bladder cancer (7), Incontinence (2) | Laparoscopic modified keyhole technique | Colostomy (83), ileal conduit (7) | Unspecified | Parietex (88), Physiomesh (2) | Intraperitoneal | Seroma (4) | 4 (2 with Physiomesh; 2 with Parietex) | 12 | The addition of some precautions to the laparoscopic KH technique makes it feasible and safe, with good results in terms of complications and rates of recurrence. The best results were associated with the use of Parietex compared to Physiomesh |
S. Rajapandian [26] | 2019 | Retrospective study | 23 | Abdominoperineal resection (14), perineal trauma (3), and uncontrolled perineal sepsis (1); total proctocolectomy (2), carcinoma bladder (3) | Modified laparoscopic keyhole plus repair | Colostomy (18); ileostomy (2); ileal conduit (3) | 0 | Composite mesh | Intraperitoneal | Seroma (3) | 23 | 1 | The laparoscopic modified keyhole plus repair technique is a safe, feasible, and effective PH repair when performed by experienced surgeons. It has an accept- able recurrence rate and offers good cosmesis and functional outcomes |
C. Bertoglio [37] | 2020 | Retrospective study | 30 | Miles (28), Harmann's (2), Cystoprostatectomy (2) | Keyhole (19), Sandwich Repair (13) | Colostomy (30), urostomy (2) | 5 | Gore-Tex Dual-Mesh (KH), DynaMesh-IPOM (SR) | Intraperitoneal | KH: parietal hematoma (1), Chronic seroma (2), bowel perforation (1). SB: chronic pain (1) | 47 | 5 (KH); 0 (SR) | Laparoscopic treatment of parastomal hernias with the “Sandwich Repair” technique seems to offer promising results, with a lower recurrence rate and less complications than the “Keyhole” technique |
V. A. Gameza [24] | 2020 | Nonrandomized case-controlled prospective study | 90 | Cancer (51), IBD (43), Miscellaneous (41) | Keyhole technique (74), Sugarbaker technique (61) | Colostomy (90), ileostomy (41), urostomy (4) | 40 | Two-layer mesh of PPM and ePTFE (72), Coated lightweight mesh of polypropylene (63) | Intraperitoneal | Intraoperative lesion of bowel (keyhole 9 vs sugarbaker 5) Stomal outlet obstruction (3 vs 3) Stoma-cutaneous fistula (0 vs 1) Peristomal infection (2 vs 0) Intra-abdominal bleeding (1 vs 0) Peritonitis (3 vs 3) | 57 (kH); 11 (SB) | Keyhole group (5) Sugarbaker group (6) | Study indicates that the Keyhole repair compares favorably with the Sugarbaker repair, provided a polypropylene mesh with an antiadhesive layer is used. With regard to early postoperative complications, recurrence, and late mesh-related morbidity, the Keyhole repair produces outcomes equal to the Sugarbaker technique |
P. Keller [30] | 2020 | Retrospective study | 62 | Unspecified | Laparoscopic Sugarbaker repair (LPHR) or open (OPHR) | Colostomy (24) | Unspecified | Unspecified | Onlay, sublay, intraperitoneal | Wound complication (laparoscopic 9 vs open 16), Seroma/hematoma (8 vs 5), Superficial SSI (3 vs 10), Deep SSI (2 vs 7), Dehiscence (1 vs 9) | 43 (LPHR), 12 (OPHR) | 6 (LPHR), 20 (OPHR) | Laparoscopic repair of the parastomal hernia is associated with a shorter operating time, a reduction in the length of stay in the hospital, fewer short-term complications of wounds, and a longer service life than open repairs. Direct comparison of repair longevity between LPHR and OPHR with mesh using Kaplan–Meier estimation is unique to this study. Further studies are needed to better understand the methods of parastomal hernia repair associated with minor complications and increased duration |
F. Tang [50] | 2020 | Prospective, observational study | 16 | Rectectomy (Mile surgery) (16), Colectomy (5), Radical cystectomy (1), Traumatic intestinal rupture (1) | Sugarbaker technique | Colostomy (16), Ileostomy (6), Ileal orthotopic neobladder (1) | 11 | Composite-polyester mesh (PCO-PM 20) | Intraperitoneal | Dyspnea (1), seroma (1), intestinal obstruction (2), urinary infection (2), wound infection (1) | 24 | 0 | PPP causes a significant increase in abdominal volumes preoperatively, thereby facilitating the total reintegration of the bowel into the abdominal cavity. Through the progressive increase of VAC, PPP induces respiratory adaptation to the elevat ed intra-abdominal pressure following hernia repair |
A. G. Barranquero [36] | 2023 | Retrospective dual-center observational study | 38 | Sigmoidectomy (3), low anterior resection (12), abdominoperineal resection (21) | Sandwich technique | Loop colostomy (2), end colostomy (36) | 11 | TiMesh® (29), DynaMesh® IPOM (9) | Intraperitoneal | Seroma (15), Surgical site infection (2), Hematoma (3), Postoperative ileus (1) | 39 | 3 | The recurrence rates observed in the sandwich technique were in line with the rates documented in the current literature. Postoperative complications emerged as the primary risk factor for hernia recurrence in our study |
J. Bellido-Luque [35] | 2023 | Prospective study | 12 | Abdominoperineal resection for rectal cancer (10); Hartmann (2) | Extraperitoneal modified Sugarbaker | End colostomy (12) | Unspecified | Optilene Mesh elastic | Retrorectus/left preperitoneal spaces | Subcutaneous emphysema (2); Seroma (2); partial bowel obstruction (1) | 29 ± 5.7 | 0 | This technique shows a low rate of intraoperative and postoperative complications with significant improvement in terms of pain and activities restriction compared to preoperatively |
Robotic approach | |||||||||||||
V. Maciel [16] | 2018 | Case report | 2 | Chronic fecal incontinence (1); low rectal cancer (1) | Retro-rectus robotic parastomal hernia | Colostomy (2) | 0 | Polypropylene macroporous mesh and a keyhole is created | Retromuscular plane | Obstructive symptoms (1) | 12 | 0 | This technique was successfully performed in two patients, without relapse after a year. The results suggest that this technique may offer an effective repair option, although it is more complex and time-consuming than other techniques such as laparoscopic Sugarbaker |
S. A. Ayuso [17] | 2020 | Prospective study | 4 | Oncological (12) IBD (3) | Sugarbaker technique | Colostomy (4), ileostomy (6), urostomy (5) | 0 | Gore Dual-Mesh® (13), Strattice™ (2) | Intraperitoneal | Pneumonia (1) | 14.2 ± 9.4 | 1 | This study describes a novel technique in which robotic parastomal hernia repair is performed with closure of the fascial defect. This study describes a technique that is safe, technically feasible, with low short-term hernia recurrence rates and low complication rates |
M. Kyle [44] | 2021 | Retrospective study | 16 | Unspecified | Modified Sugarbaker technique | Ileostomy (7), colostomy (16), urostomy (1) | Unspecified | Synecor IP, gore BIO-A and Dual-Mesh | Intraperitoneal | Bowel obstruction (1), seroma (4), intestinal incarceration (1), colonic impingement (1), pneumonia (1), atrial fibrillation (2) | Unspecified | 0 | The robot-assisted repair of parastomal hernias is a reliable and reproducible procedure with few complications. Further long-term research is necessary to assess recurrence rates and potential late complications |
J. R. Lambrecht [45] | 2021 | Prospective observational study | 11 | Abdomino-perineal resection for rectal cancer (11). anal incontinence (1), ulcerative colitis(1), constipation (1), urinary incontinence (1) | Endoscopic preperitoneal parastomal hernia repair (ePauli repair) | Colostomy (11), ileostomy (3), urostomy (1) | 5 | Dynamesh, uncoated synthetic mid-weight non-absorbable mesh with Bio-A synthetic absorbable mesh placed as barrier between the mesh and the bowel | Retromuscular plane | Serosa lesion (1), obstruction (2) | 10 | 1 | With our limited experience, we are encouraged with the pain, complication, and functional summary after ePauli repair and hopeful for the recurrence profle. ePauli/TAR is not for every patient or every surgeon and whether it should be restrained to recurrent PSH or be ofered as frst-line treatment for PSH is disputable |
M. Dewulf [15] | 2022 | Prospective study | 20 | Rectal cancer (13), IBD, anal incontinence, anal fistula, constipation, diverticulitis | Pauli procedure | Colostomy (20), ileostomy (5), urostomy (1) | 8 | Large-pore, synthetic and nonabsorbable of polypropylene, or polyester material | Retromuscular plane | Serosa lesions (7), stoma necrosis (1), ileus (3), hematoma or seroma (4) | 14 | 1 | The Pauli technique was developed to decrease recurrence rates compared to key-hole retromuscular techniques, decrease surgical site occurrences compared to re-location techniques and to keep mesh away from the abdominal cavity |