Is laparotomy mandatory for parastomal hernia repair?
OBJECTIVE
A parastomal hernia is an incisional hernia at the site of an intestinal stoma. The incidence varies, as do techniques for repair and their associated rates of success. The aim of this study was to evaluate the methods of parastomal hernia repair and their outcome.


PATIENTS AND METHODS
Between 1988 and 1998, 33 patients who underwent elective parastomal hernia repair were identified by the use of a computerized database. Information was collected on the indication and type of reparative procedure, as well as any morbidity or recurrence, post-operative complications and recurrence. The operative procedures performed included reanastomosis and ipsilateral and contralateral relocation with hernia repair. Additional data were collected on whether a laparotomy was required or mesh was placed.


RESULTS
The commonest operation was relocation without laparotomy or mesh (36%), followed by laparotomy still without mesh (21%); the overall recurrence rate was 9% (3/33) at a mean follow up of 55.2 months (range 10-108 months).


CONCLUSION
Parastomal hernia repair without laparotomy or mesh is a safe and effective method of repair.