PERISTOMAL HERNIA; THE IDEAL MANAGEMENT

Document Type : Original Article

Author

Departement of General Surgery, Colorectal Surgery Unit, Mansoura University Hospital, Egypt

Abstract

Aim: Peristomal hernia is a distressing complication of intestinal stomas that is mostly due to one or more 
technical errors. In this study, stoma repositioning within rectus sheath will be evaluated as a line of 
treatment. 
Methods: Thirteen patients (8 females and 5 males) were operated upon two to five years after operations of 
abdomino-perineal resection of malignant lesions of the lower rectum with terminal left pelvic colostomy 
who developed peristomal hernias. The colon was prepared and under general anaesthesia, an elliptical 
incision was done around the stoma, hernia was reduced, the sac excised, stoma was freed and new stoma 
site was created through rectus sheath. Parastomal hernias were dealt with through laparotomy if associated 
with incisional hernia. Peristomal hernia defect was closed using prolene mesh in an inlay manner. 
Results: There was no intraoperative complications. Postoperative complications included delayed 
colostomy function in 5 cases, seroma formation in 5 cases and infected seroma in 2 cases. The patients were 
convenient with the newly designed stoma, which was cosmetically better and functionally good
Conclusion: Peristomal hernia is one of avoidable hernias. Stoma repositioning within the rectus sheath is 
one of the most suitable lines of treatment of peristomal hernia. 

Keywords