Simultaneous Treatment of Complex Incisional Hernia and Stoma Reversal

• Published in: Journal of Abdominal Wall Surgery 2023, Vol.2, p.11093-11093
• Main Authors: Olona, Carles, Sales, Ricard, Caro-Tarragó, Aleidis, Espina, Beatriz, Casanova, Raquel, Jorba, Rosa
• Format: Article
• Language: English
• Subjects: complex incisional hernia; Health Archive; incisional hernia; ostomal hernia; ostomy reversal; simultaneous surgery
• ISSN: 2813-2092; 2813-2092
• DOI: 10.3389/jaws.2023.11093

The simultaneous repair of incisional hernias (IH) and the reconstruction of the intestinal transit may pose a challenge for many surgeons. Collaboration between units specialized in abdominal wall and colorectal surgery can favor simultaneous treatment. Descriptive study of patients undergoing simultaneous surgery of complex IH repair and intestinal transit reconstruction from the start of treatment in a joint team. All interventions were performed electively and with the collaboration of surgeons experts in abdominal wall and colorectal surgery. 23 patients are included. 11 end colostomies, 1 loop colostomy, 6 end ileostomies and 5 loop ileostomies. Seven (30%) patients presented with a medial laparotomy incisional hernia, 3 (13%) with a parastomal incisional hernia, and 13 (56%) with a medial and parastomal incisional hernia. Closure of the hernial defect was achieved in 100% of cases, and reconstruction of the intestinal tract was achieved in 22 (95%). Component separation was required in 17 patients (74%), which were 11 (48%) posterior and 6 (26%) anterior. In-hospital morbidity was 9%, and only two patients presented Clavien-Dindo morbidity > III when requiring reoperation, one due to hemorrhage of the surgical bed and another due to dehiscence of the coloproctostomy. The mean follow-up was 11 months, with 20 (87%) patients having no complications. Mesh had to be removed in one patient with anastomotic dehiscence, no mesh had to be removed due to surgical site infection.