Download PDF
Zentralbl Chir 2008; 133(5): 464-467
DOI: 10.1055/s-2008-1076958
Übersicht

© Georg Thieme Verlag Stuttgart ˙ New York

Operative Versorgung und Strategien zur Prophylaxe parastomaler Hernien

Surgical Treatment and Prophylaxis of Parastomal HerniasR. Rosch1 , K. Junge1 , G. Böhm1 , J. Conze1 , V. Schumpelick1
  • 1Chirurgische Klinik und Poliklinik, Universitätsklinik der RWTH Aachen
Further Information

Publication History

Publication Date:
15 October 2008 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Trotz der Weiterentwicklung operativer Techniken bleibt die parastomale Hernie eine chirurgische Herausforderung. Durch die Einführung der Netzplastiken konnten die Rezidivraten gesenkt werden. Die Therapie parastomaler Hernien stellt jedoch weiterhin ein relevantes klinisches Problem dar. Unter den differenten Netzverfahren hat sich die retromuskuläre Netzplastik etabliert, der Stellenwert anderer Verfahren ist bislang nicht abschließend zu beurteilen. Aufgrund der problematischen Versorgung kommt der Primärprophylaxe mit Netzimplantation eine besondere Bedeutung zu. Ihre grundsätzliche Anwendung muss jedoch angesichts möglicher kurz- und langfristiger Risiken in weiteren Studien geprüft werden.

Abstract

Despite the progress concerning operative techniques, parastomal hernias remain a surgical challenge. The high risk for recurrence demands precise indications for operative repair. Mesh implants reduce the recurrence rate. Among such procedures, the retromuscular mesh augmentation represents an established method, whereas the value of other techniques still has to be defined. Also, the prophylactic use of meshes is able to reduce the incidence of parastomal hernias. With regard to short- and long-term complications, their general recommendation must be proven in further studies.

Schlüsselwörter

parastomale Hernie - Netzimplantation - Hernienreparation - Hernienrezidiv - Prävention

Key words

parastomal hernia - mesh implantation - hernia repair - hernia recurrence - prevention

Literatur

  • 1 Abrams B L, Alsikafi F H, Waterman N G. Colostomy: a new look at morbidity and mortality.  Am Surg. 1979;  45 462-464
    PubMedGoogle Scholar
  • 2 Aldridge A J, Simson J N. Erosion and perforation of colon by synthetic mesh in a recurrent paracolostomy hernia.  Hernia. 2001;  5 110-112
    CrossrefPubMedGoogle Scholar
  • 3 Allen-Mersh T G, Thomson J P. Surgical treatment of colostomy complications.  Br J Surg. 1988;  75 416-418
    CrossrefPubMedGoogle Scholar
  • 4 Allen-Mersh T G, Thomson J P. Surgical treatment of colostomy complications.  Br J Surg. 1988;  75 416-418
    CrossrefPubMedGoogle Scholar
  • 5 Baig M K, Larach J A, Chang S et al. Outcome of parastomal hernia repair with and without midline laparotomy.  Tech Coloproctol. 2006;  10 282-286
    CrossrefPubMedGoogle Scholar
  • 6 Bayer I, Kyzer S, Chaimoff C. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia.  Surg Gynecol Obstet. 1986;  163 579-580
    PubMedGoogle Scholar
  • 7 Bickel A, Shinkarevsky E, Eitan A. Laparoscopic repair of paracolostomy hernia.  J Laparoendosc Adv Surg Tech A. 1999;  9 353-355
    PubMedGoogle Scholar
  • 8 Birnbaum W, Perrier P. Complications of abdominal colostomy.  Am J Surg. 1952;  83 64-67
    CrossrefPubMedGoogle Scholar
  • 9 Botet X, Boldo E, Llaurado J M. Colonic parastomal hernia repair by translocation without formal laparotomy.  Br J Surg. 1996;  83 981
    PubMedGoogle Scholar
  • 10 Burns F J. Complications of colostomy.  Dis Colon Rectum. 1970;  13 448-450
    CrossrefPubMedGoogle Scholar
  • 11 Carne P W, Robertson G M, Frizelle F A. Parastomal hernia.  Br J Surg. 2003;  90 784-793
    CrossrefPubMedGoogle Scholar
  • 12 Cevese P G, D'Amico D F, Biasiato R et al. Peristomal hernia following end-colostomy: a conservative approach.  Ital J Surg Sci. 1984;  14 207-209
    PubMedGoogle Scholar
  • 13 Cheung M T. Complications of an abdominal stoma: an analysis of 322 stomas.  Aust N Z J Surg. 1995;  65 808-811
    PubMedGoogle Scholar
  • 14 de Ruiter P, Bijnen A B. Successful local repair of paracolostomy hernia with a newly developed prosthetic device.  Int J Colorectal Dis. 1992;  7 132-134
    CrossrefPubMedGoogle Scholar
  • 15 Deol Z K, Shayani V. Laparoscopic parastomal hernia repair.  Arch Surg. 2003;  138 203-205
    PubMedGoogle Scholar
  • 16 Edwards D P, Leppington-Clarke A, Sexton R et al. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial.  Br J Surg. 2001;  88 360-363
    CrossrefPubMedGoogle Scholar
  • 17 Gogenur I, Mortensen J, Harvald T et al. Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation.  Dis Colon Rectum. 2006;  49 1131-1135
    CrossrefPubMedGoogle Scholar
  • 18 Gould J C, Ellison E C. Laparoscopic parastomal hernia repair.  Surg Laparosc Endosc Percutan Tech. 2003;  13 51-54
    CrossrefPubMedGoogle Scholar
  • 19 Horgan K, Hughes L E. Para-ileostomy hernia: failure of a local repair technique.  Br J Surg. 1986;  73 439-440
    CrossrefPubMedGoogle Scholar
  • 20 Israelsson L A. Preventing and treating parastomal hernia.  World J Surg. 2005;  29 1086-1089
    CrossrefPubMedGoogle Scholar
  • 21 Janes A, Cengiz Y, Israelsson L A. Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia.  Br J Surg. 2004;  91 280-282
    CrossrefPubMedGoogle Scholar
  • 22 Kald A, Landin S, Masreliez C et al. Mesh repair of parastomal hernias: new aspects of the Onlay technique.  Tech Coloproctol. 2001;  5 169-171
    CrossrefPubMedGoogle Scholar
  • 23 Kasperk R, Klinge U, Schumpelick V. The repair of large parastomal hernias using a midline approach and a prosthetic mesh in the sublay position.  Am J Surg. 2000;  179 186-188
    CrossrefPubMedGoogle Scholar
  • 24 Kasperk R, Willis S, Klinge U et al. Update Narbenhernie. Parastomale Hernie.  Chirurg. 2002;  73 895-898
    CrossrefPubMedGoogle Scholar
  • 25 Köhler L. Parastomale Hernie-Technik und Ergebnisse.  Zentralbl Chir. 1997;  122 889-892
    PubMedGoogle Scholar
  • 26 LeBlanc K A, Bellanger D E, Whitaker J M et al. Laparoscopic parastomal hernia repair.  Hernia. 2005;  9 140-144
    CrossrefPubMedGoogle Scholar
  • 27 Leslie D. The parastomal hernia.  Surg Clin North Am. 1984;  64 407-415
    PubMedGoogle Scholar
  • 28 Londono-Schimmer E E, Leong A P, Phillips R K. Life table analysis of stomal complications following colostomy.  Dis Colon Rectum. 1994;  37 916-920
    CrossrefPubMedGoogle Scholar
  • 29 Marimuthu K, Vijayasekar C, Ghosh D et al. Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study.  Colorectal Dis. 2006;  8 672-675
    CrossrefPubMedGoogle Scholar
  • 30 Martin L, Foster G. Parastomal hernia.  Ann R Coll Surg Engl. 1996;  78 81-84
    PubMedGoogle Scholar
  • 31 Morris-Stiff G J, Hughes L E. The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience.  J Am Coll Surg. 1998;  186 352-367
    CrossrefPubMedGoogle Scholar
  • 32 Nagy A, Kovacs T, Bognar J et al. Parastomal hernia repair and prevention with PHSL type mesh after abdomino-perineal rectum extirpation.  Zentralbl Chir. 2004;  129 149-152
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Ortiz H, Sara M J, Armendariz P et al. Does the frequency of paracolostomy hernias depend on the position of the colostomy in the abdominal wall?.  Int J Colorectal Dis. 1994;  9 65-67
    CrossrefPubMedGoogle Scholar
  • 34 Pearl R K. Parastomal hernias.  World J Surg. 1989;  13 569-572
    CrossrefPubMedGoogle Scholar
  • 35 Pearl R K, Prasad M L, Orsay C P et al. Early local complications from intestinal stomas.  Arch Surg. 1985;  120 1145-1147
    PubMedGoogle Scholar
  • 36 Rosin J D, Bonardi R A. Paracolostomy hernie repair with Marlex mesh: a new technique.  Dis Colon Rectum. 1977;  20 (4) 299-302
    CrossrefPubMedGoogle Scholar
  • 37 Rubin M S, Schoetz Jr D J, Matthews J B. Parastomal hernia. Is stoma relocation superior to fascial repair?.  Arch Surg. 1994;  129 413-418
    CrossrefPubMedGoogle Scholar
  • 38 Safadi B. Laparoscopic repair of parastomal hernias: early results.  Surg Endosc. 2004;  18 676-680
    CrossrefPubMedGoogle Scholar
  • 39 Sjodahl R, Anderberg B, Bolin T. Parastomal hernia in relation to site of the abdominal stoma.  Br J Surg. 1988;  75 339-341
    CrossrefPubMedGoogle Scholar
  • 40 Stelzner S, Hellmich G, Ludwig K. Sugerbaker technique in para-colostomy hernia. An analysis of personal experiences.  Zentralbl Chir. 1999;  124 Suppl 2 13-17
    PubMedGoogle Scholar
  • 41 Sugarbaker P H. Peritoneal approach to prosthetic mesh repair of paraostomy hernias.  Ann Surg. 1985;  201 344-346
    CrossrefPubMedGoogle Scholar
  • 42 Turnbull R B, Weakley F L. An atlas of intestinal stomas. St. Louis: Mosby; 1967: 78–91
    Google Scholar
  • 43 Williams J G, Etherington R, Hayward M W et al. Paraileostomy hernia: a clinical and radiological study.  Br J Surg. 1990;  77 1355-1357
    CrossrefPubMedGoogle Scholar

Dr. med. R. Rosch

Chirurgische Klinik und Poliklinik · Universitätsklinik der RWTH Aachen

Pauwelsstr. 30

52074 Aachen

Phone: +49 / 2 41 / 8 08 95 00

Fax: +49 / 2 41 / 8 08 24 17

Email: r.rosch@chir.rwth-aachen.de