Single center experience with the modified retromuscular Sugarbaker technique for parastomal hernia repair

L. Tastaldi, I. N. Haskins, A. J. Perez, A. S. Prabhu, S. Rosenblatt, M. J. Rosen

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Purpose: Parastomal hernias are challenging to manage, and an optimal repair has yet to be defined. An open, modified, retromuscular Sugarbaker technique has recently been described in the literature as a technically feasible approach to parastomal hernia repair. This study evaluates our initial institutional experience with parastomal hernia repair with the aforementioned technique with respect to safety and durability. Methods: All patients who underwent an open, modified retromuscular Sugarbaker parastomal hernia repair from 2014 through 2016 at our institution were identified. Patient characteristics, hernia variables, operative details, and 30-day and medium-term outcomes were abstracted from the Americas Hernia Society Quality Collaborative database. Outcomes of interest included 30-day wound morbidity, mesh-related complications, and hernia recurrence. Results: Thirty-eight patients met inclusion criteria. 20 (53%) patients presented to our institution for management of a recurrent parastomal hernia. 35 (92%) patients had a concurrent midline incisional hernia with a mean total hernia width of 15.1 cm and mean defect size of 353 cm2. Thirty-day wound morbidity rate was 13%. At a mean of follow-up of 13 months (range 4–30), the hernia recurrence rate was 11%. Three patients (8%) experienced mesh erosion into the stoma bowel, leading to stoma necrosis, bowel obstruction, and/or perforation which required reoperation at day 8, 12, and 120 days, respectively. Conclusions: The outcomes of the retromuscular Sugarbaker technique for the management of parastomal hernias have been disappointing at our institution, with a concerning rate of serious mesh-related complications. This operation, as originally described, needs further study before widespread adoption with a particular focus on the technique of mesh placement, the most appropriate mesh selection, and the long-term rate of mesh erosion.

Original languageEnglish (US)
Pages (from-to)941-949
Number of pages9
JournalHernia
Volume21
Issue number6
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Keywords

  • Incisional hernia
  • Parastomal hernia
  • Posterior component separation
  • Sugarbaker
  • Transversus abdominis release

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Single center experience with the modified retromuscular Sugarbaker technique for parastomal hernia repair'. Together they form a unique fingerprint.

Cite this