Carne PW, Robertson GM, Frizelle FA, et al.
The British journal of surgery. Date of publication 2003 Jul 1;volume 90(7):784-93.
1. Br J Surg. 2003 Jul;90(7):784-93.
Parastomal hernia.
Carne PW(1), Robertson GM, Frizelle FA.
Author information:
(1)Colorectal Unit, Department of Surgery, Christchurch Hospital, Riccarton
Avenue, Christchurch, New Zealand.
Comment in
Br J Surg. 2003 Oct;90(10):1306; author reply 1306-7.
BACKGROUND: Parastomal hernia following formation of an ileostomy or colostomy is
common. This article reviews the incidence of hernia, the technical factors
related to the construction of the stoma that may influence the incidence, and
the success of the different methods of repair.
METHODS: A literature search using the Medline database was performed to locate
English language articles on parastomal hernia. Further articles were obtained
from the references cited in the literature initially reviewed.
RESULTS: Parastomal hernia affects 1.8-28.3 per cent of end ileostomies, and
0-6.2 per cent of loop ileostomies. Following colostomy formation, the rates are
4.0-48.1 and 0-30.8 per cent respectively. Site of stoma formation (through or
lateral to rectus abdominis), trephine size, fascial fixation and closure of
lateral space are not proven to affect the incidence of hernia. The role of
extraperitoneal stoma construction is uncertain. Mesh repair gives a lower rate
of recurrence (0-33.3 per cent) than direct tissue repair (46-100 per cent) or
stoma relocation (0-76.2 per cent).
CONCLUSION: The incidence of parastomal hernia is between 0 and 48.1 per cent,
depending on the type of stoma and length of follow-up. No technical factors
related to the construction of the stoma have been shown to prevent herniation.
If repair is required, a prosthetic mesh technique should be considered. Further
randomized clinical trials (particularly of extraperitoneal stoma construction)
are needed.
Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley &
Sons, Ltd.
DOI: 10.1002/bjs.4220
PMID: 12854101 [Indexed for MEDLINE]
