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Abstract
Rationale. Due to the improvement of prognosis through adjuvant therapy, the life expectancy of neoplasia patients is continuously
increasing, which, in conjunction with the progressive occurrence of parastomal hernias during the disease evolution, explains the
growing number of reported parastomal hernias affecting patients with permanent colostomy.
Conventional techniques of local repair are inappropriate considering the high recurrence rate, and the decision of stoma relocation
depends on the associated pathology, which may counter-indicate general anesthesia, and on previous surgical interventions that
are usually followed by a dense peritoneal adhesion syndrome.
Objective. The purpose of this article is to make known a variant of alloplastic technique, without translocation, with a low degree of
invasiveness, which can be performed successfully under spinal anesthesia, followed by a reduced period of hospitalization.
Methods and Results. The study group consisted of 6 patients with permanent left iliac anus who underwent these interventions
one to three years prior to the occurrence of parastomal hernia.
Patients were followed at 1 year and 2 years postoperatively and the results were favorable, with no recurrence and improved quality
of life through proper prosthesis of the stoma.
Discussion. We suggest that this technique variation is applied to small and medium parastomal hernias, in case of patients with
permanent left iliac anus, with the declared intent of minimal invasiveness.
Keywords: parastomal hernia, minimal invasive, alloplastic procedure, quality of life
Introduction
Colostomy represents a solution, which is
frequently used in colorectal surgery, as a mandatory
gesture in surgical techniques such as rectum amputation
or Hartmanns operation. The surgical technique variants
are well known and can be performed in open or
laparoscopic surgery [11,14].
JournalofMedicineandLifeVol.5,Issue2,AprilJune2012
52% clinical
78% CT
47 %
45 %
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JournalofMedicineandLifeVol.5,Issue2,AprilJune2012
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JournalofMedicineandLifeVol.5,Issue2,AprilJune2012
Conclusions
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JournalofMedicineandLifeVol.5,Issue2,AprilJune2012
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
Arumgam
PJ,
Bevan
L,
Macdonald L, Watkins A. A
prospective audit of stomasanalysis of risk factors and
complications
and
their
management.
Colorectal
Dis.
2003;5(1):49-52.
Cingi A, Cakir T, Sever A, Aktan
AO. Enterostomy Site Hernias: A
Clinical
and
Computerized
Tomographic Evaluation. Dis Colon
Rectum. 2006;49 (10):15591563.
Baig MK, Larach JA, Chang S.
Outcome of parastomal hernia
repair with and without midline
laparotomy. Tech Coloproctol.
2006;10:282286.
Balalau C, Strambu V, Calin M,
Paduraru M, Popa B, Popa F.
Tratamentul
eventratiilor
pericolostoma, varianta de tehnica
alloplastica fara transpozitie. Al 23lea Congres National de Chirurgie
Baile Felix, Chirurgia. 24-27 mai
2006;vol. 101, nr. 2(S).
Carne PWG, Robertson GM,
Frizelle FA. Parastomal hernia. Br
J Surg. 2003;90:784-793.
Department of Surgery and
Perioperative Science, Ume
University, Sweden, Parastomal
hernia treatment with prosthetic
mesh repair, der Chirurg, 2010 Mar
Chirurg. 2010 Mar;81(3):216-21.
De Raet J, Delvaux G, Haentjens
P, et al. Waist circumference is an
independent risk factor for the
development of parastomal hernia
after permanent colostomy. Dis
Colon Rectum. 2008; 51:1806-9.
Duchesne JC, Wang YZ,
Weintraub SL, Boyle M, Hunt JP.
Stoma complications: a multivariate
analysis,
Am
Surg.
Nov
2002;68(11):961-6; discussion 966.
Gogenur I, Mortensen J, Harvald
T, Rosenberg J, Fischer A.
10.
11.
12.
13.
14.
15.
16.
17.
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