Hernia最新文献

{"title":"Surgery for primary ventral hernias and risk of postoperative pain, nausea: a population-based register study.","authors":"Fathalla Ali, Göran Wallin, Rebecka Rubenson Wahlin, Agneta Montgomery, Peder Rogmark, Gabriel Sandblom","doi":"10.1007/s10029-025-03256-4","DOIUrl":"https://doi.org/10.1007/s10029-025-03256-4","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate risk factors for postoperative pain and nausea after open repair for primary ventral hernias.</p><p><strong>Method: </strong>A population-based registry study was conducted based on data assembled from the Swedish national ventral hernia repair register between January 2016 and December 2021and cross-matched with the Swedish perioperative register.</p><p><strong>Results: </strong>Altogether 2064 open ventral hernia repairs were registered, including 816 (39.5%) performed on women. Of these, 91 (4.4%) were registered to suffer postoperative nausea or vomiting (PONV) and 403 (19.5%) postoperative pain (PP). In both univariable and multivariable logistic regression analyses, significant predictors of postoperative nausea and pain included male gender, which was associated with lower odds of both postoperative nausea (multivariable OR: 0.30, 95% CI: 0.18-0.49, P < 0.001) and postoperative pain (multivariable OR: 0.60, 95% CI: 0.44-0.83, P = 0.002). Additional predictors of postoperative nausea included emergency surgery (multivariable OR: 4.08, 95% CI: 1.10-15.08, P = 0.035), operative time > 40 min (multivariable OR: 4.15, 95% CI: 2.24-7.69, P < 0.001). Conversely total intravenous anesthesia was associated with lower incidence of PONV (multivariable OR: 0.40, 95% CI: 0.22-0.74, P = 0.003). Other factors, such as age, BMI, smoking status, ASA classification, hernia size, surgery type, operative time, and anesthesia type, were not significantly associated with postoperative pain after adjusting for other variables.</p><p><strong>Conclusion: </strong>Postoperative nausea and vomiting (PONV) are significantly reduced with total intravenous anesthesia (TIVA) compared to inhalation anesthesia, with no notable difference in postoperative pain between the two methods.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"68"},"PeriodicalIF":2.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Edoardo Bassini 1844-1924.","authors":"Marc Soler","doi":"10.1007/s10029-025-03258-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03258-2","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"67"},"PeriodicalIF":2.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do transversus abdominis plane (TAP) blocks improve pain after laparoscopic bilateral inguinal hernia repairs beyond the recovery unit? A randomized control trial.","authors":"Alexandra Z Agathis, Edward R Mathney, Madeleine S Higgins, Lauren S Tufts, Jeanne Z Wu, Marc Sherwin, Linda P Zhang, Celia M Divino","doi":"10.1007/s10029-025-03261-7","DOIUrl":"https://doi.org/10.1007/s10029-025-03261-7","url":null,"abstract":"<p><strong>Purpose: </strong>While surgeons agree that perioperative field blocks should be performed for open inguinal hernia surgery, there lacks consensus in the minimally invasive context. Prior small-scale randomized trials study pain scores only up to 24 h postoperatively. Thus, we sought to investigate the analgesic benefits of a bupivacaine transversus abdominis plane (TAP) block in the first 4 postoperative days.</p><p><strong>Methods: </strong>This is a prospective single-institution randomized control trial involving patients undergoing elective totally extraperitoneal inguinal hernia repairs, who received either a TAP block with bupivacaine 0.25% or saline placebo. Postoperatively, patients completed a pain survey (based on a 0-10 visual analog score) and an opioid/non-opioid pain medication log. Differences were detected using a Wilcoxon rank sum test for continuous variables, and a Fisher's exact test or chi-squared for categorical variables.</p><p><strong>Results: </strong>A total n = 90 patients were included in the per-protocol analysis, of which n = 46 received TAP blocks with bupivacaine versus n = 44 placebo. Patient characteristics were similar between the groups, including recurrent hernias and number of tacks placed (p > 0.05). All cases were bilateral. Postoperatively, pain scores (at rest and with movement) and pain medication use were similar for all postoperative days 1-4.</p><p><strong>Conclusion: </strong>Our study shows no significant difference in pain or opioid requirement within the first 4 days postoperatively, suggesting that the analgesic benefits of plain bupivacaine TAP blocks in totally extraperitoneal inguinal hernia repairs do not exist beyond the recovery unit. This will help inform anesthesiologists and patients in discussing risks and benefits of a TAP block in their surgical context.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"66"},"PeriodicalIF":2.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved outcomes after groin hernia surgery in Sweden between 1992 and 2021: Swedish Hernia Register.","authors":"Erik Axman, Henrik Holmberg, Erik Nilsson, Johanna Österberg, Ursula Dahlstrand, Agneta Montgomery, Pär Nordin, Hanna de la Croix","doi":"10.1007/s10029-025-03257-3","DOIUrl":"10.1007/s10029-025-03257-3","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery for groin hernia is one of the most common operations in the world. Therefore, research concerning the outcomes of groin hernia surgery is extremely important both for the individual patient as well as for those providing the healthcare funding. The aim of this study is to evaluate the outcomes of hernia surgery in Sweden over a 30 year time period, from 1992 to 2021.</p><p><strong>Methods: </strong>All groin hernia repairs in the Swedish Hernia Register between 1992 to 2021 were analyzed with emphasis on the surgical method, reoperation rate for recurrence and date of surgery, specifically 1992-2001, 2002-2011 and 2012-2021. By using personal identification numbers, a cumulative reoperation rate has been deduced for males and females separately.</p><p><strong>Results: </strong>A total of 368,502 groin hernia operations identified in the Swedish Hernia Register between 1992 to 2021 were eligible for analysis. Since the register was begun, there have been significant changes in the choice of operative techniques, from suture repair in 1992 to open anterior mesh repair around the year 2000, until today, where an increasing proportion of hernias are repaired using laparo-endoscopic techniques. There has been a reduction in the reoperation rate for recurrence in both males and females, with the most pronounced improvement being seen in females. The laparo-endoscopic technique is associated with a reduced incidence of reoperation for recurrence in females.</p><p><strong>Conclusion: </strong>Groin hernia surgery in Sweden has undergone substantial changes over the past 30 years. Reoperation for recurrence has decreased significantly during recent years, especially in females.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"65"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior component separation techniques: is it necessary to preserve the perforators? a systematic review and meta-analysis.","authors":"Mariana de Macedo Torves, Carlos André Balthazar da Silveira, Raquel Nogueira, Leandro Totti Cavazzola, Diego L Lima","doi":"10.1007/s10029-024-03243-1","DOIUrl":"10.1007/s10029-024-03243-1","url":null,"abstract":"<p><strong>Background: </strong>Anterior component separation (ACS), or Ramirez component separation technique, is an established technique still used by surgeons to repair a ventral hernia. Compared with other ventral hernia repair techniques, recent studies about ACS show more postoperative complications like wound breakdown, wound infection, hematoma, skin necrosis, seroma, and recurrence. Our study aims to compare the ACS technique with the preservation perforator technique and verify if the perforator preservation technique can decrease postoperative complications.</p><p><strong>Materials and methods: </strong>Cochrane Central, Embase, and PubMed were systematically searched for studies comparing the perforator-sparing ACS ventral hernia repair and the standard technique. Outcomes assessed were wound breakdown, skin necrosis, wound infection, seroma, hematoma, reoperation, and recurrence at least 3 months postoperatively. Statistical analysis was performed with R Studio.</p><p><strong>Results: </strong>94 studies were screened, and 11 studies were selected for full-text reading. Seven studies were selected, comprising 761 patients, of which 309 (40.6%) underwent the perforator-sparing ACS technique. We found lower wound breakdown rates for the preservation technique (RR 0.45; 95% CI 0.32; 0.63; p < 0.01). Also, the perforator-sparing technique presented lower reoperation rates (RR 0.59; 95% CI 0.35; 0.72; p < 0.01). No differences were found in skin necrosis (RR 0.22; 95% CI 0.03; 1.63; p = 0.14), wound infection (RR 0.69; 95% CI 0.25; 1.90; p = 0.47), seroma (RR 0.29; 95% CI 0.07; 1.26; p = 0.1), hematoma (RR 0.73; 95% CI 0.11; 5.06; p = 0.75), or recurrence (RR 0.81; 95% CI 0.37; 1.74; p = 0.59) rates.</p><p><strong>Conclusion: </strong>Our comprehensive systematic review with meta-analysis compared the perforator-sparing ACS with the standard technique and found lower wound breakdown and reoperation rates for the perforator-sparing technique. No differences were found in the other outcomes analyzed.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"64"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic postoperative inguinal pain (CPIP) after pediatric inguinal hernia repair-a retrospective analysis.","authors":"A Widder, H Bucher, A K Reinhold, L Maroske, T Meyer, A Wiegering, J F Lock, C -T Germer, H L Rittner, N Schlegel, Michael Meir","doi":"10.1007/s10029-024-03245-z","DOIUrl":"https://doi.org/10.1007/s10029-024-03245-z","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of inguinal hernias in children is one of the most common operative procedures worldwide. During surgery for inguinal hernias in adults, chronic pain develops in approximately 10% of all cases. In children, there has been limited research to determine whether they may also develop this chronic postsurgical inguinal pain (CPIP). The aim of this study was to investigate the prevalence of CPIP in children after open inguinal hernia surgery and to identify possible risk factors and protective factors for the development of CPIP.</p><p><strong>Methods: </strong>A single center retrospective analysis of patients aged 4 to 15 years who underwent inguinal hernia repair from 2020 to 2022 was performed. A detailed analysis based on the local database was used to analyze existing pre-existing conditions, perioperative information and the use of a cauda epidural block. A standardized follow-up questionnaire was used to evaluate the prevalence of CPIP and the duration of postoperative analgesic medication.</p><p><strong>Results: </strong>A total of 176 cases were included in the detailed analysis. 3.4 % of the children complained CPIP 3 months after surgery with a mean follow-up period of 26.4 months. At the time of the survey, 50% of CPIP patients reported a resolving from chronic pain. Our analyzes showed a potential higher CPIP rate in females (83.3%; p=0.040), older children (8.3 years vs. 5 years; p=0.006) and chronic pain history (16.7% vs. 2.4%; p=0.038).Furthermore, Children mitght profit from a intraoperative cauda epidural block since we observed a lower rate of CPIP (66.7% (4/6) vs. 97% (164/170); p=0.019) in these patients.</p><p><strong>Conclusion: </strong>We were able to identify initial risk factors such as female gender, older patient age and a history of chronic pain. In addition, we were able to obtain information on possible protective factors such as an intraoperative cauda epidural block and adequate postoperative analgesia. However, further studies are required to clarify the pathogenesis and to confirm predictors and protective factors in order to improve therapeutic approaches.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"62"},"PeriodicalIF":2.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeons transitioning from laparoscopic to robotic-assisted inguinal hernia repair: a prospective analysis of efficiency.","authors":"William W Hope, James G Bittner, Rana C Pullatt, William L Newcomb, Jose Erbella, Steven D Thies, Juan-Carlos Verdeja","doi":"10.1007/s10029-024-03218-2","DOIUrl":"10.1007/s10029-024-03218-2","url":null,"abstract":"<p><strong>Background: </strong>Available reports of surgeon efficiency when transitioning from laparoscopic to robotic-assisted (RA) inguinal hernia repair (IHR) are retrospective or describe single-center experience. The purpose of this study is to provide a prospective, multi-surgeon, multi-center assessment of surgeon efficiency when transitioning from Lap-IHR to RA-IHR.</p><p><strong>Methods: </strong>General surgeons with Lap-IHR experience (≥300 Lap-IHRs prior to the study) but with no robotic experience (no RA cases one year prior to the study) consented to participate in this prospective, observational pilot study of their surgical efficiency as they adopted RA-IHR. Efficiency was measured through procedure durations, including skin-to-skin time and time to establish critical view of the myopectineal orifice (MPO). Rates of conversions, and adverse events (AEs) through 30 days post RA-IHR procedure were also reported. Outcomes with 95% confidence intervals (95% CI) describe surgeons' collective and individual unilateral and bilateral early, middle, and late-phase cases, with each surgeon contributing 25 consecutive cases at each phase.</p><p><strong>Results: </strong>Four surgeons consented to enroll in the study and provided 75 consecutive, prospective RA-IHR cases. Collectively, the surgeons reached relative skin-to-skin time efficiencies for their unilateral repairs in the mid-phase of their prospective cases. For RA-IHR bilateral procedures, skin-to-skin time efficiency was reached in the late-phase cases. Surgeons' skin-to-skin efficiency times varied relative to their retrospective Lap-IHRs. Possible confounders included practice patterns, referrals, proctoring periods, and-for one surgeon-Covid interruptions. One conversion from RA-IHR to open resulted from severe adhesions present after prior prostatectomy. AEs varied broadly from surgeon to surgeon.</p><p><strong>Conclusions: </strong>The four surgeons improved their skin-to-skin efficiencies.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"63"},"PeriodicalIF":2.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic sugarbaker parastomal hernia repair: updated series and outcomes.","authors":"Monica E Polcz, Alexis Holland, Alynna Wiley, Sullivan A Ayuso, William Lorenz, Gregory T Scarola, Dau Ku, Vedra A Augenstein","doi":"10.1007/s10029-024-03227-1","DOIUrl":"10.1007/s10029-024-03227-1","url":null,"abstract":"<p><strong>Purpose: </strong>To present updated outcomes after previously describing a novel technique for the robotic repair of parastomal hernias.</p><p><strong>Methods: </strong>Patients who underwent parastomal hernia repair with a robotic Sugarbaker technique at a tertiary hernia center were identified from an institutional database. The approach involves mesh placement in the intraperitoneal or preperitoneal position after closure of the fascial defect. Baseline demographics, intra-operative variables, and post-operative outcomes were evaluated.</p><p><strong>Results: </strong>Twenty-six patients were identified who underwent robotic Sugarbaker parastomal hernia repair with mesh. Median age was 61.5 (IQR 58.0-67.0) years, 17 (65%) were male, and median BMI was 29.5 (IQR 25.7-32.6) kg/m². Stoma types included 11 (42%) colostomies, 8 (31%) ileostomies, and 7 (27%) urostomies. All but one case was elective (96%) and 2 (8%) were recurrent. Median operative time was 182.5 (IQR 149-209) min. Biologic mesh was used in 5 (19%) and synthetic mesh in 21 (81%) cases. Concurrent hernia repair was performed in 11 (42%) cases. Two (8%) patients were converted from a robotic to open procedure. Median length of stay was 4 (IQR 3-6) days. A total of 3 (11.5%) patients underwent reoperation related to obstruction at the stoma site. There were no additional 30-day readmissions, seromas requiring intervention, or wound complications. There were 4 (15%) total recurrences during a median follow up of 29.1 (IQR 10.0-55.8) months.</p><p><strong>Conclusions: </strong>Robotic Sugarbaker parastomal hernia repair is an effective technique for minimally invasive repair of parastomal hernias. Care should be taken to prevent obstruction of the stoma related to fascial and peritoneal flap reconstruction or mesh placement, which is a significant risk of this technique.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"61"},"PeriodicalIF":2.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of sac transection versus sac reduction on seroma in laparoscopic indirect hernia repair: a systematic review and meta-analysis.","authors":"Rui Cao, Xiangyu Shao, Junsheng Li","doi":"10.1007/s10029-024-03236-0","DOIUrl":"https://doi.org/10.1007/s10029-024-03236-0","url":null,"abstract":"<p><strong>Background: </strong>Seroma formation is a prevalent postoperative complication following laparoscopic inguinal hernia repair. While seromas are mostly self-absorbed, they can cause discomfort for the patient and complicate the assessment of hernia recurrence. Two primary techniques for managing the hernia sac are sac transection and complete sac reduction. This article aims to evaluate whether sac transection leads to a higher incidence of seroma compared to sac reduction and to review the main preventive strategies for seroma.</p><p><strong>Methods: </strong>Four databases (PubMed, MEDLINE, Embase and Cochrane Library) and ClinicalTrials.gov were comprehensively searched for relevant studies. The date of the last search was 25 March 2024. The results reported should include reliable information on seroma incidence, mean operation time, hospital stay and postoperative complications.</p><p><strong>Results: </strong>The present study included 6 studies compared the results of indirect hernia sac transection and complete sac reduction. The pooled results indicated that indirect hernia sac transection was associated increased seroma formation (OR = 1.74, 95% CI: 1.35-2.24%), and there was no statistical difference in mean operation time, hospital stay and recurrence between the sac transection (TS) and sac reduction (RS) groups. Postoperative pain was evaluated in 4 studies. There was no statistical difference between the two groups in postoperative pain reported in each of the four articles.</p><p><strong>Conclusions: </strong>The study revealed that transection of the indirect hernia sac is associated with a higher incidence of seroma, but does not increase the occurrence of other complications.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"60"},"PeriodicalIF":2.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial and recurrent management of parastomal hernia after cystectomy and ileal conduit urinary diversion: a 10 year single-center experience.","authors":"Edouard Roussel, Hugo Dupuis, Julien Grosjean, Jean-Nicolas Cornu, Haitham Khalil","doi":"10.1007/s10029-024-03207-5","DOIUrl":"https://doi.org/10.1007/s10029-024-03207-5","url":null,"abstract":"<p><strong>Purpose: </strong>The management of parastomal hernia following cystectomy and ileal conduit diversion is challenging due to its specific nature and a high recurrence rate, yet is poorly described.</p><p><strong>Methods: </strong>We retrospectively searched the clinical data warehouse of our center for patients who had primary parastomal hernia repair following cystectomy and ileal conduit diversion. The primary endpoint was recurrence of parastomal hernia; secondary endpoints were postoperative complications and surgical management of recurrences.</p><p><strong>Results: </strong>From January 1st 2012 to January 1st 2022, 35 patients were included in the study, 13 patients (37.1%) were operated with the Keyhole technique and 22 patients (62.9%) with the Sugarbaker technique. The median follow-up was 24 months. The main complication was urinary tract infection, in 6 patients (17.4%). Postoperative complications were severe in 4 patients (11.4%), 3 (8.6%) for prosthesis extraction due to infection. Ninety-day mortality was null. Eight patients (22.9%) had a symptomatic recurrence of parastomal hernia leading to a second surgery, 4 patients (30.7%) in the Keyhole group and 4 patients (18.2%) in the Sugarbaker group. Surgical management of recurrences involved repair without synthetic mesh in 4 patients (50%) due to difficult adhesiolysis, leading to a third surgery for 3 patients (37.5%).</p><p><strong>Conclusion: </strong>The high rates of recurrence observed with the Keyhole technique, in particular, but also with the Sugarbaker technique, suggest that these techniques should no longer be used for the repair of parastomal hernia after ileal conduit urinary diversion. New preventive and curative approaches need to be explored to improve the surgical management of parastomal hernia.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"57"},"PeriodicalIF":2.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}