THE CONTINUING CHALLENGE OF PARASTOMAL HERNIA - FAILURE OF A NOVEL POLYPROPYLENE MESH REPAIR

In an attempt to reduce the high recurrence rate after repair of paras tomal hernia, a technique was devised in which non-absorbable mesh was used to provide a permanent closure of the gap between the emerging b owel and abdominal wall.Seven patients were treated during the period 1990-1992. Five-year follow-up has given disappointing results, with r ecurrent hernia in 29% of cases and serious complications, including o bstruction and dense adhesions to the intra-abdominal mesh, in 57% and a mesh-related abscess in 15% of cases. This study highlights a dual problem-failure of a carefully sutured mesh to maintain an occlusive p osition, and complications of the mesh itself. The poor results obtain ed with this technique together with the disappointing results with ot her methods described in the literature confirms that parastomal herni a presents a continuing challenge.