Parastomal hernia. A study of the French federation of ostomy patients

Summary Introduction The prevalence of parastomal hernia (PSH) varies considerably in the literature. This condition impacts negatively on quality of life. Yet there is no surgical consensus concerning treatment. The aim of the study was to determine treatment and recurrence rates of PSH in a large...

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Bibliographic Details
Published in:Journal of visceral surgery 2011-12, Vol.148 (6), p.e435-e441
Main Authors: Ripoche, J, Basurko, C, Fabbro-Perray, P, Prudhomme, M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
France - epidemiology
Hernia, Ventral - epidemiology
Hernia, Ventral - etiology
Hernia, Ventral - surgery
Herniorrhaphy - methods
Humans
Incidence
Male
Middle Aged
Ostomy - adverse effects
Quality of Life
Recurrence
Retrospective Studies
Risk Factors
Surgery
Surveys and Questionnaires
Time Factors
Treatment Outcome
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Summary:Summary Introduction The prevalence of parastomal hernia (PSH) varies considerably in the literature. This condition impacts negatively on quality of life. Yet there is no surgical consensus concerning treatment. The aim of the study was to determine treatment and recurrence rates of PSH in a large population of ostomy patients. Patients and methods This retrospective study was carried out by a self-administered questionnaire in a population drawn at random from the database of the French federation of ostomy patients (FSF). Results Seven hundred and eighty-two patients were eligible for the study. The mean duration of follow-up was 10.5 years. PSH was reported by 202 patients (25.6%) and appeared on average 18 months after creation of the stoma. In multivariate analysis, ileostomy had a lower risk of developing PSH than did colostomy; age mote than 60 years and peristomal complications at the time of stoma creation increased the risk. Only 24% of patients with PSH were free from symptoms related to the hernia. The main complaints were pain (35%), difficulties in fitting a stomal appliance with leakage (28%); 114 patients (56%) underwent operative repair. The morbidity rate of reoperation was 33%, and 57 patients (52%) had recurrence of PSH within an average of 6 months. Transposition of the stoma to another location and the use of prosthetic mesh decreased recidivism AF recurrence? Conclusion PSH aggravates the inherently diminished quality of life of stoma patients. There are many proposed surgical treatments but recurrence occurs in more than half of patients. Randomized trials on the treatment of PSH are nonexistent. The use of a prosthetic mesh may reduce the risk of recurrence. The prophylactic use of prophylactic mesh at the time of initial stoma formation is a strategy worthy of consideration.
ISSN:1878-7886
1878-7886
DOI:10.1016/j.jviscsurg.2011.10.006