Surgical treatment of parastomal hernia complicating sigmoid colostomies

PURPOSE: Parastomal hernia is a common late complication of colostomy. Surg ical approach to the repair of parastomal hernia is controversial. Results of surgical treatment are disappointing. The aim of this study was to asses s the outcome of surgical treatment of parastomal hernia. METHOD: This arti cle reports a retrospective review of those patients who had undergone a su rgical treatment of parastomal hernia complicating sigmoid colostomy. The i ndications, surgical procedures, complications, and outcome were carefully studied. RESULTS: There were 43 surgical treatments of parastomal hernia. S ixteen underwent simple local repair; 25 stomas were relocated, and 2 were locally repaired with mesh. Overall recurrence was 18 of 10 (45 percent). R ecurrences for fascial repair and stoma relocation were 6 of 13 (46 percent ) and 10 of 25 (40 percent), respectively. Stoma relocation could be accomp lished without formal laparotomy in 19 of 25 cases. Incisional hernia occur red in only 2 of these 25 relocations. CONCLUSION: Fascial repair alone can be performed for symptomatic small hernias because of its advantage of min imal morbidity. Stoma relocation without formal laparotomy can be advocated for larger hernias. A combination of local resite together with mesh reinf orcement may be the alternative for further improvement of results.