INTRODUCTION: Patients with concomitant large midline incisional and parastomal hernias present many unique challenges to the reconstructive surgeon. METHODS: We describe a novel approach of simultaneously repairing the midline incisional and parastomal defect, while prophylactically reinforcing the relocated stoma site with a retrorectus biological graft. RESULTS: During the study period, 9 men and 3 women with a mean age of 65 years, body mass index (BMI) 34 kg/m2, and American Society of Anesthesiologists score (ASA) 3.1 underwent repair. Hernia defects averaged 338 cm2. Seven patients had a myofascial advancement flap. Mean operative time was 277 minutes. Postoperative complications occurred in 4 patients (33%) and included superficial surgical site infection, transient renal failure, and deep venous thrombosis; in addition, 1 patient died suddenly on postoperative day 3. After a mean follow-up of 14 months, 2 patients have asymptomatic hernia recurrence. CONCLUSIONS: The use of various advanced abdominal wall reconstructive techniques may offer an acceptable approach to repairing these challenging defects. Copyright (c) 2010. Published by Elsevier Inc.
INTRODUCTION:Patients with concomitant large midline incisional and parastomal hernias present many unique challenges to the reconstructive surgeon. METHODS: We describe a novel approach of simultaneously repairing the midline incisional and parastomal defect, while prophylactically reinforcing the relocated stoma site with a retrorectus biological graft. RESULTS: During the study period, 9 men and 3 women with a mean age of 65 years, body mass index (BMI) 34 kg/m2, and American Society of Anesthesiologists score (ASA) 3.1 underwent repair. Hernia defects averaged 338 cm2. Seven patients had a myofascial advancement flap. Mean operative time was 277 minutes. Postoperative complications occurred in 4 patients (33%) and included superficial surgical site infection, transient renal failure, and deep venous thrombosis; in addition, 1 patient died suddenly on postoperative day 3. After a mean follow-up of 14 months, 2 patients have asymptomatic hernia recurrence. CONCLUSIONS: The use of various advanced abdominal wall reconstructive techniques may offer an acceptable approach to repairing these challenging defects. Copyright (c) 2010. Published by Elsevier Inc.
Authors: E B Deerenberg; L Timmermans; D P Hogerzeil; J C Slieker; P H C Eilers; J Jeekel; J F Lange Journal: Hernia Date: 2014-11-08 Impact factor: 4.739
Authors: Nicholas Jonathan Slater; Bibi M E Hansson; Otmar R Buyne; Thijs Hendriks; Robert P Bleichrodt Journal: J Gastrointest Surg Date: 2011-03-01 Impact factor: 3.452