Clin Colon Rectal Surg 2016; 29(03): 277-284
DOI: 10.1055/s-0036-1584506
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Parastomal Hernia: Avoidance and Treatment in the 21st Century

Sean C. Glasgow
1   Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
2   USAF Center for the Sustainment of Trauma and Resuscitative Skills (C-STARS), St. Louis, Missouri
,
Sekhar Dharmarajan
1   Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
3   John Cochrane VA Medical Center, St. Louis, Missouri
› Author Affiliations
Further Information

Publication History

Publication Date:
19 August 2016 (online)

Abstract

Despite medical and surgical advances leading to increased ability to restore or preserve gastrointestinal continuity, creation of stomas remains a common surgical procedure. Every ostomy results in a risk for subsequent parastomal herniation, which in turn may reduce quality of life and increase health care expenditures. Recent evidence-supported practices such as utilization of prophylactic reinforcement, attention to stoma placement, and laparoscopic-based stoma repairs with mesh provide opportunities to both prevent and successfully treat parastomal hernias.

 
  • References

  • 1 Hendren S, Hammond K, Glasgow SC , et al. Clinical practice guidelines for ostomy surgery. Dis Colon Rectum 2015; 58 (4) 375-387
  • 2 Carne PW, Robertson GM, Frizelle FA. Parastomal hernia. Br J Surg 2003; 90 (7) 784-793
  • 3 Kald A, Juul KN, Hjortsvang H, Sjödahl RI. Quality of life is impaired in patients with peristomal bulging of a sigmoid colostomy. Scand J Gastroenterol 2008; 43 (5) 627-633
  • 4 Scarpa M, Ruffolo C, Boetto R, Pozza A, Sadocchi L, Angriman I. Diverting loop ileostomy after restorative proctocolectomy: predictors of poor outcome and poor quality of life. Colorectal Dis 2010; 12 (9) 914-920
  • 5 Aquina CT, Iannuzzi JC, Probst CP , et al. Parastomal hernia: a growing problem with new solutions. Dig Surg 2014; 31 (4–5) 366-376
  • 6 Sjödahl R, Anderberg B, Bolin T. Parastomal hernia in relation to site of the abdominal stoma. Br J Surg 1988; 75 (4) 339-341
  • 7 Evans MD, Thomas C, Beaton C, Williams GL, McKain ES, Stephenson BM. Lowering the incidence of stomal herniation: further follow up of the lateral rectus abdominis positioned stoma. Colorectal Dis 2011; 13 (6) 716-717
  • 8 Stephenson BM, Evans MD, Hilton J, McKain ES, Williams GL. Minimal anatomical disruption in stoma formation: the lateral rectus abdominis positioned stoma (LRAPS). Colorectal Dis 2010; 12 (10) 1049-1052
  • 9 Hardt J, Meerpohl JJ, Metzendorf MI, Kienle P, Post S, Herrle F. Lateral pararectal versus transrectal stoma placement for prevention of parastomal herniation. Cochrane Database Syst Rev 2013; 11: CD009487
  • 10 Elliot-Smith A, Painter NS. Experiences with extraperitoneal colostomy and ileostomy. Gut 1961; 2: 360-362
  • 11 Goligher JC. Extraperitoneal colostomy or ileostomy. Br J Surg 1958; 46 (196) 97-103
  • 12 Londono-Schimmer EE, Leong AP, Phillips RK. Life table analysis of stomal complications following colostomy. Dis Colon Rectum 1994; 37 (9) 916-920
  • 13 Hamada M, Ozaki K, Muraoka G, Kawakita N, Nishioka Y. Permanent end-sigmoid colostomy through the extraperitoneal route prevents parastomal hernia after laparoscopic abdominoperineal resection. Dis Colon Rectum 2012; 55 (9) 963-969
  • 14 Lian L, Wu XR, He XS , et al. Extraperitoneal vs. intraperitoneal route for permanent colostomy: a meta-analysis of 1,071 patients. Int J Colorectal Dis 2012; 27 (1) 59-64
  • 15 López-Cano M, Lozoya-Trujillo R, Quiroga S , et al. Use of a prosthetic mesh to prevent parastomal hernia during laparoscopic abdominoperineal resection: a randomized controlled trial. Hernia 2012; 16 (6) 661-667
  • 16 Nastro P, Knowles CH, McGrath A, Heyman B, Porrett TR, Lunniss PJ. Complications of intestinal stomas. Br J Surg 2010; 97 (12) 1885-1889
  • 17 Hammond TM, Huang A, Prosser K, Frye JN, Williams NS. Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study. Hernia 2008; 12 (5) 475-481
  • 18 Figel NA, Rostas JW, Ellis CN. Outcomes using a bioprosthetic mesh at the time of permanent stoma creation in preventing a parastomal hernia: a value analysis. Am J Surg 2012; 203 (3) 323-326 , discussion 326
  • 19 Fleshman JW, Beck DE, Hyman N, Wexner SD, Bauer J, George V ; PRISM Study Group. A prospective, multicenter, randomized, controlled study of non-cross-linked porcine acellular dermal matrix fascial sublay for parastomal reinforcement in patients undergoing surgery for permanent abdominal wall ostomies. Dis Colon Rectum 2014; 57 (5) 623-631
  • 20 Bayer I, Kyzer S, Chaimoff C. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia. Surg Gynecol Obstet 1986; 163 (6) 579-580
  • 21 Berger D. Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST). Hernia 2008; 12 (3) 243-246
  • 22 Hauters P, Cardin JL, Lepere M, Valverde A, Cossa JP, Auvray S. Prevention of parastomal hernia by intraperitoneal onlay mesh reinforcement at the time of stoma formation. Hernia 2012; 16 (6) 655-660
  • 23 Marimuthu K, Vijayasekar C, Ghosh D, Mathew G. Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study. Colorectal Dis 2006; 8 (8) 672-675
  • 24 Vijayasekar C, Marimuthu K, Jadhav V, Mathew G. Parastomal hernia: is prevention better than cure? Use of preperitoneal polypropylene mesh at the time of stoma formation. Tech Coloproctol 2008; 12 (4) 309-313
  • 25 Jänes A, Cengiz Y, Israelsson LA. Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia. Br J Surg 2004; 91 (3) 280-282
  • 26 Jänes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh: a 5-year follow-up of a randomized study. World J Surg 2009; 33 (1) 118-121 , discussion 122–123
  • 27 Gögenur I, Mortensen J, Harvald T, Rosenberg J, Fischer A. Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation. Dis Colon Rectum 2006; 49 (8) 1131-1135
  • 28 Serra-Aracil X, Bombardo-Junca J, Moreno-Matias J , et al. Randomized, controlled, prospective trial of the use of a mesh to prevent parastomal hernia. Ann Surg 2009; 249 (4) 583-587
  • 29 Shabbir J, Chaudhary BN, Dawson R. A systematic review on the use of prophylactic mesh during primary stoma formation to prevent parastomal hernia formation. Colorectal Dis 2012; 14 (8) 931-936
  • 30 Brandsma HT, Hansson BM, Aufenacker TJ , et al. Prophylactic mesh placement to prevent parastomal hernia, early results of a prospective multicentre randomized trial. Hernia 2015;
  • 31 Vierimaa M, Klintrup K, Biancari F , et al. Prospective, randomized study on the use of a prosthetic mesh for prevention of parastomal hernia of permanent colostomy. Dis Colon Rectum 2015; 58 (10) 943-949
  • 32 Williams NS, Hotouras A, Bhan C, Murphy J, Chan CL. A case-controlled pilot study assessing the safety and efficacy of the Stapled Mesh stomA Reinforcement Technique (SMART) in reducing the incidence of parastomal herniation. Hernia 2015; 19 (6) 949-954
  • 33 Williams NS, Nair R, Bhan C. Stapled mesh stoma reinforcement technique (SMART)—a procedure to prevent parastomal herniation. Ann R Coll Surg Engl 2011; 93 (2) 169
  • 34 Erwin-Toth P, Thompson SJ, Davis JS. Factors impacting the quality of life of people with an ostomy in North America: results from the Dialogue Study. J Wound Ostomy Continence Nurs 2012; 39 (4) 417-422 , quiz 423–424
  • 35 Randall J, Lord B, Fulham J, Soin B. Parastomal hernias as the predominant stoma complication after laparoscopic colorectal surgery. Surg Laparosc Endosc Percutan Tech 2012; 22 (5) 420-423
  • 36 Israelsson LA. Preventing and treating parastomal hernia. World J Surg 2005; 29 (8) 1086-1089
  • 37 Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Wara P, Bisgaard T. Risk of morbidity, mortality, and recurrence after parastomal hernia repair: a nationwide study. Dis Colon Rectum 2013; 56 (11) 1265-1272
  • 38 Al Shakarchi J, Williams JG. Systematic review of open techniques for parastomal hernia repair. Tech Coloproctol 2014; 18 (5) 427-432
  • 39 Hansson BM, Slater NJ, van der Velden AS , et al. Surgical techniques for parastomal hernia repair: a systematic review of the literature. Ann Surg 2012; 255 (4) 685-695
  • 40 McLemore EC, Harold KL, Efron JE, Laxa BU, Young-Fadok TM, Heppell JP. Parastomal hernia: short-term outcome after laparoscopic and conventional repairs. Surg Innov 2007; 14 (3) 199-204
  • 41 Pastor DM, Pauli EM, Koltun WA, Haluck RS, Shope TR, Poritz LS. Parastomal hernia repair: a single center experience. JSLS 2009; 13 (2) 170-175
  • 42 Riansuwan W, Hull TL, Millan MM, Hammel JP. Surgery of recurrent parastomal hernia: direct repair or relocation?. Colorectal Dis 2010; 12 (7) 681-686
  • 43 Rubin MS, Schoetz Jr DJ, Matthews JB. Parastomal hernia. Is stoma relocation superior to fascial repair?. Arch Surg 1994; 129 (4) 413-418 , discussion 418–419
  • 44 Hotouras A, Murphy J, Thaha M, Chan CL. The persistent challenge of parastomal herniation: a review of the literature and future developments. Colorectal Dis 2013; 15 (5) e202-e214
  • 45 Cingi A, Cakir T, Sever A, Aktan AO. Enterostomy site hernias: a clinical and computerized tomographic evaluation. Dis Colon Rectum 2006; 49 (10) 1559-1563
  • 46 Guzmán-Valdivia G. Incisional hernia at the site of a stoma. Hernia 2008; 12 (5) 471-474
  • 47 Allen-Mersh TG, Thomson JP. Surgical treatment of colostomy complications. Br J Surg 1988; 75 (5) 416-418
  • 48 Rosin JD, Bonardi RA. Paracolostomy hernia repair with Marlex mesh: a new technique. Dis Colon Rectum 1977; 20 (4) 299-302
  • 49 Slater NJ, Hansson BM, Buyne OR, Hendriks T, Bleichrodt RP. Repair of parastomal hernias with biologic grafts: a systematic review. J Gastrointest Surg 2011; 15 (7) 1252-1258
  • 50 Sugarbaker PH. Peritoneal approach to prosthetic mesh repair of paraostomy hernias. Ann Surg 1985; 201 (3) 344-346
  • 51 Asif A, Ruiz M, Yetasook A , et al. Laparoscopic modified Sugarbaker technique results in superior recurrence rate. Surg Endosc 2012; 26 (12) 3430-3434
  • 52 Hansson BM, Morales-Conde S, Mussack T, Valdes J, Muysoms FE, Bleichrodt RP. The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study. Surg Endosc 2013; 27 (2) 494-500
  • 53 Mizrahi H, Bhattacharya P, Parker MC. Laparoscopic slit mesh repair of parastomal hernia using a designated mesh: long-term results. Surg Endosc 2012; 26 (1) 267-270
  • 54 Berger D, Bientzle M. Laparoscopic repair of parastomal hernias: a single surgeon's experience in 66 patients. Dis Colon Rectum 2007; 50 (10) 1668-1673
  • 55 Berger D, Bientzle M. Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia 2009; 13 (2) 167-172
  • 56 Halabi WJ, Jafari MD, Carmichael JC , et al. Laparoscopic versus open repair of parastomal hernias: an ACS-NSQIP analysis of short-term outcomes. Surg Endosc 2013; 27 (11) 4067-4072
  • 57 Fevang BT, Fevang J, Lie SA, Søreide O, Svanes K, Viste A. Long-term prognosis after operation for adhesive small bowel obstruction. Ann Surg 2004; 240 (2) 193-201