Dataset Information

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study.

ABSTRACT:

Background

Parastomal hernia is a common complication of stoma formation and the methods of repair available today are unsatisfactory with high recurrence and complication rates. To improve outcome after surgical repair of parastomal hernia, a surgical method using autologous full-thickness skin grafts as intraperitoneal reinforcement has been developed. The purpose of this study was to evaluate the feasibility of this novel surgical technique in the repair of parastomal hernia.

Methods

A pilot study was conducted between January 2018 and June 2019 on four patients with symptomatic parastomal hernia. They had a laparotomy with suture reduction of the hernia and reinforcement of the abdominal wall with autologous full-thickness skin. They were then monitored for at least 1 year postoperatively for technique-related complications and recurrence.

Results

No major technique-related complications were noted during the follow-up Two patients developed a recurrent parastomal hernia at the long term follow-up. The other two had no recurrence.

Conclusions

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair is feasible and should be evaluated in a larger clinical trial.

SUBMITTER: Holmdahl V

PROVIDER: S-EPMC7847461 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study.

Holmdahl V V Gunnarsson U U Strigård K K

Techniques in coloproctology 20201105 1

<h4>Background</h4>Parastomal hernia is a common complication of stoma formation and the methods of repair available today are unsatisfactory with high recurrence and complication rates. To improve outcome after surgical repair of parastomal hernia, a surgical method using autologous full-thickness skin grafts as intraperitoneal reinforcement has been developed. The purpose of this study was to evaluate the feasibility of this novel surgical technique in the repair of parastomal hernia.<h4>Metho ...[more]

PMID: 33151386

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Project description:BackgroundAspiring endoscopic surgery with extraperitoneal mesh application to avoid adhesion and pain from mesh fixation, we adopted the principles of the open Pauli repair of parastomal hernia (PSH). We have termed the procedure ePauli repair. The aim of this account is to inform about feasibility and adverse reactions.MethodsPatients with PSH selected for ePauli repair with transversus abdominis release (TAR) were enrolled in a prospective observational study. Patients were operated with laparoscopic or robotic assistance and endoscopic Rives-Stoppa repair in cases with concomitant midline hernia. Coated meshes or a buffer mesh was used in the retromuscular pocket for this modification of the Sugarbaker principle.ResultsFifteen patients were included: six patients were operated laparoscopically and nine patients with robotic assistance. The median age of the stomas was 33 months (7-313). Five PSHs were recurrent after previous repairs. Median operating time without midline hernia repair was 156 min (107-233) and with midline hernia repair 241 min (176-286). One serosa lesion arose during operation, prompting intraoperative revision of the ostomy without postoperative morbidity. Two patients had postoperative obstruction and were readmitted to operation: one with multiple adhesions and one had kinking of the stoma bowel caused by insufficient incision of the transversalis fascia. No infections or seromas have been observed. One patient had discoloring of the flank with spontaneous remission, and one patient had recurrence. Median postoperative admission time was 3 days (1-19). Median follow-up is 10 months (0-27).ConclusionsePauli repair is technically challenging but feasible. With our limited experience, we are encouraged with the pain, complication, and functional summary after ePauli repair and hopeful for the recurrence profile. ePauli/TAR is not for every patient or every surgeon and whether it should be restrained to recurrent PSH or be offered as first-line treatment for PSH is disputable.

Dataset Information

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study.

Background

Methods

Results

Conclusions

Publications

Autologous full-thickness skin graft as reinforcement in parastomal hernia repair: a feasibility study.

Similar Datasets

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