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Open Access 01-06-2021 | Parastomale Hernie | Original Scientific Report

Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up

Authors: Elisa Mäkäräinen-Uhlbäck, Jaana Vironen, Ville Falenius, Pia Nordström, Anu Välikoski, Jyrki Kössi, Aristotelis Kechagias, Maija Kalliala, Anne Mattila, Tuomo Rantanen, Tom Scheinin, Pasi Ohtonen, Tero Rautio

Published in: World Journal of Surgery | Issue 6/2021

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.

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Title: Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up
Authors: Elisa Mäkäräinen-Uhlbäck
Jaana Vironen
Ville Falenius
Pia Nordström
Anu Välikoski
Jyrki Kössi
Aristotelis Kechagias
Maija Kalliala
Anne Mattila
Tuomo Rantanen
Tom Scheinin
Pasi Ohtonen
Tero Rautio
Publication date: 01-06-2021
Publisher: Springer International Publishing
Keyword: Parastomale Hernie
Published in: World Journal of Surgery / Issue 6/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-021-05990-z

At a glance: The STEP trials

Springer Medicine

Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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