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Fu YY, Ma Y, Zhang CK, Sun LH, Tang D, Wang W, Wang DR. The clinical applications of D-type parastomal hernia repair surgery. Hernia 2024; 28:427-434. [PMID: 38170300 DOI: 10.1007/s10029-023-02924-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE This study investigated the use of a modified laparoscopic repair of paraostomy hernia technique, called "D-Type parastomal hernia repair surgery" which combines abdominal wall and extraperitoneal stoma reconstruction, in patients with parastomal hernia (PSH) following colorectal stoma surgery. The aim was to determine whether D-type parastomal hernia repair surgery is a promising surgical approach compared to the traditional laparoscopic repair technique (Sugarbaker method) for patients with PSH. METHODS PSH patients were selected and retrospectively divided into two groups: the study group underwent D-type parastomal hernia repair, while the control group underwent laparoscopic Sugarbaker repair. Clinical data from both groups were analyzed. RESULT Compared to control group (n = 68), the study group undergoing D-type stoma lateral hernia repair had significant increase in total operative time (98.82 ± 12.37 min vs 124.61 ± 34.99 min, p < 0.001). The study group also showed better postoperative stoma bowel function scores in sensory ability, frequency of bowel movements, and clothing cleanliness without a stoma bag (p = 0.037, 0.001, 0.002). The treatment cost was significantly higher in the control group (3899.97 ± 260.00$ vs 3215.91 ± 230.03$, p < 0.001). The postoperative recurrence rate in the control group was 26.4%, while in the study group, it was 4.3%, with a significant statistical difference (p = 0.024). In terms of long-term postoperative complications, the study group had an overall lower incidence compared to the control group (p = 0.035). Other parameters showed no significant differences between the two groups. CONCLUSION The study suggests that D-type parastomal hernia repair surgery is a safe and feasible procedure. Compared to traditional surgery, it can reduce the recurrence of lateral hernia, improve postoperative stoma bowel function, and save medical resources.
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Affiliation(s)
- Y Y Fu
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Medical College of Yangzhou University, Yangzhou, 225001, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - Y Ma
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
- Nanjing University, Nanjing, 210093, China
| | - C K Zhang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Medical College of Yangzhou University, Yangzhou, 225001, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
| | - L H Sun
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Medical College of Yangzhou University, Yangzhou, 225001, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
- Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, 225001, China
- The Fourth People's Hospital of Taizhou City, Taizhou, 225300, China
| | - D Tang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Medical College of Yangzhou University, Yangzhou, 225001, China
- Department of Gastrointestinal Surgery, Northern Jiangsu Peoples's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China
| | - W Wang
- Department of Gastrointestinal Surgery, Northern Jiangsu Peoples's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.
| | - D R Wang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
- Medical College of Yangzhou University, Yangzhou, 225001, China.
- Department of Gastrointestinal Surgery, Northern Jiangsu Peoples's Hospital, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, 225001, China.
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