Evaluating EHS parastomal hernia classification for surgical planning: a retrospective analysis of 160 consecutive cases in a single center

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2024-10, Vol.28 (5), p.1915-1923
• Main Authors: Szczepkowski, Marek, Zamkowski, Mateusz, Alicja, Suwała, Piotr, Witkowski, Śmietański, Maciej
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Classification; Endoscopy - methods; Female; Hernia; Hernia, Ventral - classification; Hernia, Ventral - etiology; Hernia, Ventral - surgery; Hernias; Herniorrhaphy - adverse effects; Herniorrhaphy - methods; Humans; Incisional Hernia - etiology; Incisional Hernia - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Ostomy - adverse effects; Patients; Retrospective Studies; Surgical Stomas - adverse effects
• ISSN: 1248-9204; 1265-4906; 1248-9204
• DOI: 10.1007/s10029-024-03121-w

Introduction Parastomal hernia (PH) is a prevalent complication following ostomy formation, presenting significant challenges in surgical management. This study aims to validate the European Hernia Society classification for PH through the application of the Hybrid Parastomal Endoscopic Repair (HyPER) method. The study focuses on establishing the practical utility of the European Hernia Society classification in a clinical setting, particularly in guiding surgical approaches and improving patient outcomes. Materials and methods This retrospective observational study aimed to assess the utility of the European Hernia Society classification in planning surgical strategies for parastomal hernias. The validation of the classification of PH was based on the experience involving 160 patients in single center. Patients were classified according to the European Hernia Society criteria, and data were collected on patient demographics, clinical presentations, and surgical outcomes. Main goal was to assess the consistency and applicability of the European Hernia Society classification in predicting surgical challenges and outcomes. Results The study found a predominance of complex Type III and IV hernias. The European Hernia Society classification was effective in categorizing PH, aiding in surgical planning and highlighting the increased complication rates associated with more complex hernia types. This study represents the largest single-center cohort treated for PH by a single team, providing a controlled evaluation of the HyPER technique’s effectiveness. Conclusions The validation of the European Hernia Society classification in this study is a significant advancement in the standardization of PH management. The findings demonstrate the classification’s utility in enhancing surgical planning and patient-centered care. The study also opens avenues for further research into standardized approaches and techniques in PH treatment.