Clinical outcomes after parastomal hernia repair with a polyester monofilament composite mesh: a cohort study of 79 consecutive patients
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Different techniques and mesh materials are used in parastomal hernia repair with recently reported recurrence rates ranging from 10 to 28%. The aim of this cohort study was to examine the risk of recurrence and chronic pain after Sugarbaker or keyhole parastomal hernia repair with intraperitoneal placement of a polyester monofilament macroporous composite mesh.
Data on all patients undergoing parastomal hernia repair with Parietex™ Composite Parastomal Mesh at our institution during a 4-year period were examined. Patients with urostomy were excluded. A team of three experienced surgeons performed all repairs. Follow-up including physical examination was done after 10 days, 6 and 12 months, and hereafter as annual structured telephone interviews. Patients suspected of hernia recurrence were offered computed tomography scan. Chronic pain was defined as pain requiring out-patient visit(s) and/or regular use of analgesics.
79 patients (Sugarbaker, n = 69; keyhole, n = 10) were included. Of those, 72 procedures were performed laparoscopically and seven by open technique. Two patients were reoperated within 30 days with removal of the mesh. In total, seven (9%) patients had parastomal hernia recurrence (reoperation, n = 3; conservative management, n = 4) during follow-up of median 12 months (range 0–49 months). In univariable logistic analyses, type of stoma was associated with recurrence (ileostomy 28% vs colostomy 3%, p = 0.007). Three patients (4%) reported chronic pain.
In this study, we found low rates of recurrence and chronic pain following parastomal hernia repair using intraperitoneal reinforcement with a polyester monofilament composite mesh.
KeywordsParastomal hernia repair Parietex parastomal mesh Recurrence Chronic pain
Stoma care nurses Trine Borglit and Mette von Rosen conducted all primary follow-ups.
Compliance with ethical standards
Sources of funding
Conflict of interest
EO has received a travel Grant from Medtronic. LNJ has received fees for educational activities and oral presentations from Medtronic, BARD and Acelity, and received funding for data collection and expert report drafting from Medtronic of the present material. BP has nothing to disclose.
According to Danish law, approval from a local ethics committee was not required.
Statement on human rights
For this type of study, formal consent is not required.
Statement on the welfare of animals
This article does not contain any studies with animals performed by any of the authors.
Statement on informed consent
According to Danish law, informed consent from included individuals are not required for this type of study.
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