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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2013

Open Access 01-02-2013

The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study

Authors: B. M. E. Hansson, S. Morales-Conde, T. Mussack, J. Valdes, F. E. Muysoms, R. P. Bleichrodt

Published in: Surgical Endoscopy | Issue 2/2013

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Abstract

Background

Parastomal hernia is a frequent complication of intestinal stomata. Mesh repair gives the best results, with the mesh inserted via laparotomy or laparoscopically. It was the aim of this retrospective multicenter study to determine the early and late results of the laparoscopically performed, modified Sugarbaker technique with ePTFE mesh.

Methods

From 2005 to 2010, a total of 61 consecutive patients (mean age = 61 years), with a symptomatic parastomal hernia, underwent laparoscopic repair using the modified Sugarbaker technique with ePTFE mesh. Fifty-five patients had a colostomy, 4 patients an ileostomy, and 2 a urostomy according to Bricker. The records of the patients were reviewed with respect to patient characteristics, postoperative morbidity, and mortality. All patients underwent physical examination after a follow-up of at least 1 year to detect a recurrent hernia. Morbidity rate was 19 % and included wound infection (n = 1), ileus (n = 2), trocar site bleeding (n = 2), reintervention (n = 2), and pneumonia (n = 1). One patient died in the postoperative period due to metastasis of lung carcinoma that caused bowel obstruction. Concomitant incisional hernias were detected in 25 of 61 patients (41 %) and could be repaired at the same time in all cases. A recurrent hernia was found in three patients at physical examination, and in one patient an asymptomatic recurrence was found on a CT scan. The overall recurrence rate was 6.6 % after a mean follow-up of 26 months.

Conclusion

The laparoscopic Sugarbaker technique is a safe procedure for repairing parastomal hernias. In our study, the overall morbidity was 19 % and the recurrence rate was 6.6 % after a mean follow-up of 26 months. Moreover, the laparoscopic approach revealed concomitant hernias in 41 % of the patients, which could be repaired successfully at the same time.
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Metadata
Title
The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study
Authors
B. M. E. Hansson
S. Morales-Conde
T. Mussack
J. Valdes
F. E. Muysoms
R. P. Bleichrodt
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 2/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2464-4

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