OC-013 MEDIUM-LONG TERM OUTCOMES OF RETROMUSCULAR PARASTOMAL HERNIA REPAIR WITH PAULI MODIFIED SUGAR BARKER PROCEDURE

Autor: J Martínez Caballero, L Román García De León, M Medina Pedrique, A Avilés Oliveros, S Morejón Ruiz, M Pérez-Flecha González, A Robin Valle Del Lersundi, J Rodríguez Muñoz, J López Monclús, L A Blazquez Hernando, M Á García Ureña
Rok vydání: 2023
Předmět:
Zdroj: British Journal of Surgery. 110
ISSN: 1365-2168
0007-1323
Popis: Objective We aim to evaluate the outcomes and stoma complication in parastomal hernia repair (PHR) with Pauli procedure. Material and Methods 18 patients were recruited between 2015–2022 in 2 hospitals. Data were obtained from prospective clinical database. Surgical technique included: posterior component separation (TAR), bowel lateralization according to Pauli modified Sugarbaker and, if necessary, stoma relocation. Quantitative variables are shown as median [interquartile rank] and qualitative as percentage. Results 22.2% patients had recurrent PH with 2 [3] previous repair attempts. 22.2% underwent bilateral TAR and 11.1% required inlay mesh. Panniculectomy was performed in 17,8% of patients and stoma relocation in 44,4%; 17% required intestinal resection and 11,1% bowel suturing. Complications < 30days: 17% had surgical site infection (SSIs), 2 deep SSIs and one required surgical management. 22.2% had clinical seroma, one required percutaneous drainage and other surgical intervention. Postoperative complications were adynamic ileus (22,2%), bowel obstruction (5%) which was managed conservatively and anastomotic leakage (5%). No mortality was observed, and hospital-stay length was 8 [7.25] days. Complications > 30days: 5.5% chronic seroma (grade III), 5.5% PTE and 22.2% bowel obstruction of which one required adhesiolysis and another bowel resection. 27.8% had any stoma-related complication: partial ischemia (5.5%), retraction (11.1%), prolapse (5.5%) and obstruction (5.5%) managed conservatively. One patient required reoperation due to stoma perforation. We found 25% of clinical or radiological recurrence after 24 [20.1] months follow-up. Conclusion This technique provides acceptable recurrence rates of the PH, but is still high, with a non-negligible associated comorbidity.
Databáze: OpenAIRE
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