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Repair of parastomal hernia after Bricker procedure: retrospective consecutive experience of a tertiary center

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Abstract

Background

Ileal conduit parastomal hernias (ICPHs) are frequent after radical cystectomy with ileal conduit urinary diversion, but their management is debated. This study aimed to review the results of ICPH repair according to Sugarbaker or Sandwich techniques, with special interest in ICPH recurrence and urological complications.

Methods

The authors reviewed a consecutive series of patients undergoing ICPH repair between January 2014 and December 2020. Primary endpoints were ICPH recurrences at clinical exam and cross-sectional abdominal computed tomography (CT) scans. Secondary endpoints were any other complications possibly related to the ICPH repair.

Results

Twenty-three patients underwent ICPH repair surgery (16 Sugarbaker and 7 Sandwich techniques) during the study period. Sixteen patients underwent a primary laparoscopic approach. All but one patient underwent at least one abdominal CT during the follow-up. Median clinical and CT scan follow-up times were 57 and 50.5 months, respectively. Clinical and CT ICPH recurrence rates were 4.5% and 13% at 5 years, respectively. Eighteen patients (78%) suffered no urological complications during the follow-up period, but three patients (13%) needed redo surgery on the urinary ileal conduit.

Conclusion

The modified Sugarbaker or Sandwich techniques might be considered as promising techniques for ICPH repair with a low rate of recurrence. The urological complications, and particularly the ileal conduit-related issues, need to be evaluated in further studies. Controlled and prospective data are required to compare the Sugarbaker and Sandwich techniques to the Keyhole approach for ICPH repairs.

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Data availability

The authors confirm that the data presented in this study will be available on request to the corresponding author.

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Funding

No funding for this study.

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Authors and Affiliations

  1. Department of Abdominal Surgery and Transplantation, Division of Abdominal Wall Surgery, CHU Liege, University of Liege, Sart Tilman B35, B4000, Liege, Belgium

    L. Goffioul, D. Zjukovitsj & O. Detry

  2. Department of Abdominal Surgery, CHR Citadelle, Liege, Belgium

    L. Goffioul

  3. Department of Radiology, CHU Liege, University of Liege, Liege, Belgium

    M. Moise

  4. Department of Urology, CHU Liege, University of Liege, Liege, Belgium

    D. Waltregny

  5. Centre de Recherche et d′Enseignement du Département de Chirurgie (CREDEC), University of Liege, Liege, Belgium

    O. Detry

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Correspondence to O. Detry.

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Conflict of interest

The authors have no financial disclosure and have no conflict of interest concerning this study. Author Lauranne Goffioul, author Daniel Zjukovitsj, author Martin Moise, author David Waltregny, Authors Olivier Detry, have no financial disclosure and have no conflict of interest concerning the study entitled "Repair of parastomal hernia after Bricker procedure: retrospective consecutive experience of a tertiary center" submitted for publication in Hernia as an original paper.

Ethics approval

The Ethical Committee of the CHU Liege, Belgium reviewed and approved this study (Reference 2022/224).

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The anonymised data are available upon request to the corresponding author.

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Supplementary Information

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Suppl Figure 1: Preoperative CT of the 23 patients. Supplementary file1 (TIFF 21592 KB)

Suppl Figure 2: Computed tomography confirming the failure of the ICPH repair. Supplementary file2 (TIFF 4398 KB)

10029_2023_2940_MOESM3_ESM.docx

Suppl Figure 3: Pre- (3A) and post- (3B) operative computed tomography a female patient suffering from a radiologically identified Moreno-Matias grade Ia recurrence (white arrow on Fig 2B) 37 months after a modified Sugarbaker procedure. Supplementary file3 (DOCX 8313 KB)

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Goffioul, L., Zjukovitsj, D., Moise, M. et al. Repair of parastomal hernia after Bricker procedure: retrospective consecutive experience of a tertiary center. Hernia (2023). https://doi.org/10.1007/s10029-023-02940-7

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