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Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up
- Source :
- World Journal of Surgery
- Publication Year :
- 2021
- Publisher :
- Springer International Publishing, 2021.
-
Abstract
- Background Parastomal hernia repair is a complex surgical procedure with high recurrence and complication rates. This retrospective nationwide cohort study presents the results of different parastomal hernia repair techniques in Finland. Methods All patients who underwent a primary end ostomy parastomal hernia repair in the nine participating hospitals during 2007–2017 were included in the study. The primary outcome measure was recurrence rate. Secondary outcomes were complications and re-operation rate. Results In total, 235 primary elective parastomal hernia repairs were performed in five university hospitals and four central hospitals in Finland during 2007–2017. The major techniques used were the Sugarbaker (38.8%), keyhole (16.3%), and sandwich techniques (15.4%). In addition, a specific intra-abdominal keyhole technique with a funnel-shaped mesh was utilized in 8.3% of the techniques; other parastomal hernia repair techniques were used in 21.3% of the cases. The median follow-up time was 39.0 months (0–146, SD 35.3). The recurrence rates after the keyhole, Sugarbaker, sandwich, specific funnel-shaped mesh, and other techniques were 35.9%, 21.5%, 13.5%, 15%, and 35.3%, respectively. The overall re-operation rate was 20.4%, while complications occurred in 26.3% of patients. Conclusion The recurrence rate after parastomal hernia repair is unacceptable in this nationwide cohort study. As PSH repair volumes are low, further multinational, randomized controlled trials and hernia registry data are needed to improve the results.
- Subjects :
- medicine.medical_specialty
Original Scientific Report
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Recurrence
Medicine
Humans
Incisional Hernia
Hernia
Finland
Herniorrhaphy
Retrospective Studies
business.industry
Surgical Stomas
Retrospective cohort study
Vascular surgery
Surgical Mesh
3126 Surgery, anesthesiology, intensive care, radiology
medicine.disease
Hernia, Ventral
3. Good health
Surgery
Surgical mesh
Cardiothoracic surgery
030220 oncology & carcinogenesis
3121 General medicine, internal medicine and other clinical medicine
030211 gastroenterology & hepatology
Neoplasm Recurrence, Local
Complication
business
Abdominal surgery
Cohort study
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 14322323 and 03642313
- Volume :
- 45
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- World Journal of Surgery
- Accession number :
- edsair.doi.dedup.....e4245babf39617533eeebf62d8661b44