Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A french multi-institutional experience

Background Parastomal incisional hernia (PH) is a frequent complication following the creation of an ileal conduit (IC), and it can be a significant detriment to quality of life. The aim of this study was to evaluate outcomes of PH repair following IC for urinary diversion. Method A multicenter retr...

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Published in:Langenbeck's archives of surgery 2023-08, Vol.408 (1), p.344-344, Article 344
Main Authors: Bel, Nicolas, Blanc, Pierre-Yves, Moszkowicz, David, Kim, Bradford, Deballon, Pablo Ortega, Berrada, Delia, Liu, David, Romain, Benoit, Ophélie, Delchet, Renard, Yohann, Passot, Guillaume
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
Cystectomy - adverse effects
General Surgery
Humans
Incisional Hernia - etiology
Incisional Hernia - surgery
Medicine
Medicine & Public Health
Quality of Life
Retrospective Studies
Thoracic Surgery
Traumatic Surgery
Urinary Diversion - adverse effects
Vascular Surgery
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Summary:Background Parastomal incisional hernia (PH) is a frequent complication following the creation of an ileal conduit (IC), and it can be a significant detriment to quality of life. The aim of this study was to evaluate outcomes of PH repair following IC for urinary diversion. Method A multicenter retrospective study was conducted of 6 academic hospitals in France. The study’s population included patients who underwent surgical treatment for parastomal hernia following IC creation from 2013 to 2021. Results Fifty-one patients were included in the study. Median follow up was 15.3 months. Eighteen patients presented with a recurrence (35%), with a median time to recurrence of 11.1 months. The vast majority of PH repair was performed through an open approach (88%). With regard to technique, Keyhole was the most reported technique (46%) followed by Sugarbaker (22%) and suture only (20%). The Keyhole technique was associated with a higher risk of recurrence compared to the Sugarbaker technique (52% vs 10%, p  = 0.046). Overall, there was a 7.8% rate of major complications without a statistical difference between PH repair techniques for major complications. Conclusion Surgical treatment of parastomal hernia following IC was associated with a high risk of recurrence. Novel surgical approaches to PH repair should be considered.
ISSN:1435-2451
1435-2451
DOI:10.1007/s00423-023-03062-5