Parastomal hernias: the current state (review)

Abstract

Every year there is an increase in the number of patients with intestinal stoma, which leads to an increase in the incidence of parastomal hernias (PSH). More than 50% of ostomy patients develop a parastomal hernia two or more years after radical surgery. To date, there are many surgical options for PSH, however, a unified algorithm for choosing an operational technique has not been evolved.The purpose of this review is to study modern surgical methods for the treatment of PSH and their late results, to determine the optimal approach and benefits.The review of the literature showed that in all cases of surgical treatment of PSH it is necessary to use mesh implants. The optimal technique for PSH hernioplasty is the laparoscopic version of Sugarbaker due to the low risk of recurrence and technical simplicity. In patients with large and giant PSH or hernia recurrence, STORRM is the technique of choice; classical stoma transposition is not used due to the high risk of recurrence. The use of Pauli/ePauli technique demonstrates a low recurrence rate, but there are no late results in this category of patients.