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Parastomal hernia

Wendy Osborne, Jacqui North, Julia Williams
All patients with a stoma are at risk of developing some degree of parastomal herniation given enough follow-up time. Based on current evidence, preventive measures are strongly advised to minimise the incidence of a parastomal hernia forming. This article explores the evidence for consistency in care and management of parastomal hernia, focusing on the development of a risk assessment tool, taking into consideration the patient's and the nurse's perspective.
March 8, 2018: British Journal of Nursing: BJN
Michael J Fitzgerald, Sarah Ullrich, Kumar Singh, Oren Misholy, Peter Kingham, Mary S Brady
Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive procedures). Of these 31 procedures, six (19%) resulted in a parastomal hernia recurrence with a median follow-up of 31 months (range 0.5-80). Four of the recurrences occurred in our initial experience, when we constructed the top hat of xenograft alone...
February 22, 2018: American Journal of Surgery
Pilar Hernández-Granados, Manuel López-Cano, Salvador Morales-Conde, Filip Muysoms, Josep García-Alamino, José Antonio Pereira-Rodríguez
Incisional hernias are a very common problem, with an estimated incidence around 15-20% of all laparotomies. Evisceration is another important problem, with a lower rate (2.5-3%) but severe consequences for patients. Prevention of both complications is an essential objective of correct patient treatment due to the improved quality of life and cost savings. This narrative review intends to provide an update on incisional hernia and evisceration prevention. We analyze the current criteria for proper abdominal wall closure and the possibility to add prosthetic reinforcement in certain cases requiring it...
February 14, 2018: Cirugía Española
Chetna Bakshi, Samantha Ruff, Frank Caliendo, Jennifer Agnew
A parastomal hernia is the abnormal protrusion of intra-abdominal tissue and organs through a defect in the abdominal wall around an ostomy. Commonly, they involve intra-abdominal fat, omentum or bowel. However, there are rare cases that involve other organs. We present the case of an 89-year-old gentleman with a gallbladder in his parastomal hernia. Due to his acute cholecystitis, the distended gallbladder compressed adjacent bowel loops in the parastomal hernia, resulting in a mechanical bowel obstruction...
December 2017: Journal of Surgical Case Reports
F Köckerling, N N Alam, S A Antoniou, I R Daniels, F Famiglietti, R H Fortelny, M M Heiss, F Kallinowski, I Kyle-Leinhase, F Mayer, M Miserez, A Montgomery, S Morales-Conde, F Muysoms, S K Narang, A Petter-Puchner, W Reinpold, H Scheuerlein, M Smietanski, B Stechemesser, C Strey, G Woeste, N J Smart
INTRODUCTION: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations...
January 31, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Shuang Chen, Taicheng Zhou
Hernia and abdominal surgery keeps moving forward rapidly In 2017, lots of progress were achieved in etiology, material, and surgical technique. In etiology, TTN gene missense mutation was found in family members of indirect inguinal hernia. In material, a long-term slow-absorptive patch was present leading to a good choice of hernia therapy; application of 3D print for individual patch repair was expected. In surgical technique, efficacy of laparoscopic minimal invasive procedure or MILOS and eMILOS procedures was satisfactory in the treatment of complicated incisional hernia; tissue separation, patch placement and abdominal wall reconstruction by robotic surgery resulted in bigger operative space, faster postoperative recovery and lower morbidity of infection and seroma at operative site...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
J S Winder, A Majumder, M Fayezizadeh, Y W Novitsky, E M Pauli
BACKGROUND: A minority of patients undergoing posterior component separation (PCS) have abdominal wall defects that preclude complete reconstruction of the visceral sac with native tissue. The use of absorbable mesh bridges (AMB) to span such defects has not been established. We hypothesized that AMB use during posterior sheath closure of PCS is safe and provides favorable outcomes. METHODS: We performed a retrospective review of consecutive patients undergoing PCS with AMB at two hernia centers...
January 18, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
A E Canda, C Terzi, C Agalar, T Egeli, C Arslan, C Altay, F Obuz
PURPOSE: Parastomal hernia is a frequent complication of an abdominal wall stoma. Surgical repairs have high complication and recurrence rates. Several different techniques have been suggested to prevent parastomal hernia during stoma creation. The aim of the present case-control study was to evaluate the efficacy of modified Stapled Mesh stomA Reinforcement Technique (SMART) for prevention of parastomal hernia compared with conventional colostomy formation in patients who underwent open or laparoscopic rectal resection and end colostomy for cancer...
January 5, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
E Oma, B Pilsgaard, L N Jorgensen
PURPOSE: 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. METHODS: Data on all patients undergoing parastomal hernia repair with Parietex™ Composite Parastomal Mesh at our institution during a 4-year period were examined...
January 3, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Jacqui North, Wendy Osborne
No abstract text is available yet for this article.
December 14, 2017: British Journal of Nursing: BJN
Wendy Osborne
Wendy Osborne, Educational Officer, ASCN UK, and Clinical Lead Ostomy Division, Coloplast Ltd, summarises the ASCN UK parastomal hernia workshop, which took place at the ASCN UK 2017 annual conference.
December 14, 2017: British Journal of Nursing: BJN
Pia Näsvall, Jörgen Rutegård, Michael Dahlberg, Ulf Gunnarsson, Karin Strigård
Purpose: Parastomal hernia is a common complication following a stoma and may cause leakage or incarceration. No optimal treatment has been established, and existing methods using mesh repair are associated with high recurrence rates and a considerable risk for short- and long-term complications including death. A double-layer intraperitoneal on-lay mesh (IPOM), the Parastomal Hernia Patch (BARD™), consisting of ePTFE and polypropylene, has been developed and tailored to avoid recurrence...
2017: Surgery Research and Practice
L F Kroese, D P V Lambrichts, J Jeekel, G J Kleinrensink, A G Menon, E J R de Graaf, W A Bemelman, J F Lange
AIM: Parastomal hernia is the most common complication following stoma construction. Surgical treatment is usually chosen over non-operative treatment, but a clear rationale for the choice of management is often lacking. This study aims to investigate the reasons for non-operative treatment, cross-over rates, and postoperative complications. METHOD: A multicentre, retrospective cohort study was conducted. Patients diagnosed with a parastomal hernia between January 2007 and December 2012 were included...
November 18, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
S A Antoniou, F Agresta, J M Garcia Alamino, D Berger, F Berrevoet, H-T Brandsma, K Bury, J Conze, D Cuccurullo, U A Dietz, R H Fortelny, C Frei-Lanter, B Hansson, F Helgstrand, A Hotouras, A Jänes, L F Kroese, J R Lambrecht, I Kyle-Leinhase, M López-Cano, L Maggiori, V Mandalà, M Miserez, A Montgomery, S Morales-Conde, M Prudhomme, T Rautio, N Smart, M Śmietański, M Szczepkowski, C Stabilini, F E Muysoms
BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched...
November 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Gregory A Dumanian, Steven T Lanier, Jason M Souza, Mimi Wu Young, Alexei S Mlodinow, Anne-Marie Boller, Kyle H Mueller, Amy L Halverson, Michael F McGee, Jonah J Stulberg
BACKGROUND: We sought to evaluate the results of a new mesh sutured repair technique for closure of contaminated incisional hernias. METHODS: 48 patients with contaminated hernias 5 cm wide or greater by CT scan were closed with mesh sutures. Surgical site occurrence, infections, and hernia recurrence were compared to similar patient series reported in the literature. RESULTS: Of the 48 patients, 20 had clean-contaminated wounds, 16 had contaminated wounds, and 12 were infected...
October 25, 2017: American Journal of Surgery
Christoffer Odensten, Karin Strigård, Jörgen Rutegård, Michael Dahlberg, Ulrika Ståhle, Ulf Gunnarsson, Pia Näsvall
OBJECTIVE: The aim of this study was to determine whether parastomal hernia (PSH) rate can be reduced by using synthetic mesh in the sublay position when constructing permanent end colostomy. The secondary aim was to investigate possible side-effects of the mesh. BACKGROUND: Prevention of PSH is important as it often causes discomfort and leakage from stoma dressing. Different methods of prevention have been tried, including several mesh techniques. The incidence of PSH is high; up to 78%...
October 23, 2017: Annals of Surgery
Peter Mekhail, Akbar Ashrafi, Mario Mekhail, David Hatcher, Monish Aron
INTRODUCTION: Parastomal hernia is a common and vexing problem after ileal conduit urinary diversion that can cause pain, bowel symptoms, and problems with the stoma appliance, resulting in leakage, odor, and impairment of quality of life. Historically, these hernias have been managed open surgically, which requires considerable dissection of the abdominal wall for mesh placement, and may also require relocating the stoma to the contralateral side. Further, open parastomal hernia repair can be a morbid procedure with recurrence rates of approximately 30%...
September 7, 2017: Urology
Peng Wang, Hao Su, Jianwei Liang, Zheng Wang, Zhixiang Zhou, Haitao Zhou
PURPOSE: This study was designed to introduce a new surgical innovation, referred to as the "Longtan modification," for cases with parastomal hernia (PSH) following intraperitoneal sigmoidostomy, and to assess the safety and feasibility of this procedure. METHODS: Between January 2013 and June 2016, a total of 26 consecutive cases with PSH successfully underwent this procedure. The patient demographics, surgical outcomes, stoma-related complications, and the stoma function were collected and analyzed...
October 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Thomas Gavigan, Nigel Rozario, Brent Matthews, Caroline Reinke
BACKGROUND: Parastomal hernia is the most common complication after stoma creation. Parastomal hernias can create significant morbidity, including patient discomfort, small bowel obstruction, and need for emergency surgery. We examined national trends in parastomal hernia repair (PHR) including annual frequency of procedure, patient characteristics, and same-admission complications. MATERIALS AND METHODS: The 1998-2011 Nationwide Inpatient Sample was used to identify patients who underwent a PHR (International Classification of Disease, Ninth Edition, Procedure Code [ICD-9 PR] 46...
October 2017: Journal of Surgical Research
Maddie White, Wendy Osborne
No abstract text is available yet for this article.
September 28, 2017: British Journal of Nursing: BJN
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