Operative Versorgung und Strategien zur Prophylaxe parastomaler Hernien

Zusammenfassung

Trotz der Weiterentwicklung operativer Techniken bleibt die parastomale Hernie eine chirurgische Herausforderung. Durch die Einführung der Netzplastiken konnten die Rezidivraten gesenkt werden. Die Therapie parastomaler Hernien stellt jedoch weiterhin ein relevantes klinisches Problem dar. Unter den differenten Netzverfahren hat sich die retromuskuläre Netzplastik etabliert, der Stellenwert anderer Verfahren ist bislang nicht abschließend zu beurteilen. Aufgrund der problematischen Versorgung kommt der Primärprophylaxe mit Netzimplantation eine besondere Bedeutung zu. Ihre grundsätzliche Anwendung muss jedoch angesichts möglicher kurz- und langfristiger Risiken in weiteren Studien geprüft werden.

Abstract

Despite the progress concerning operative techniques, parastomal hernias remain a surgical challenge. The high risk for recurrence demands precise indications for operative repair. Mesh implants reduce the recurrence rate. Among such procedures, the retromuscular mesh augmentation represents an established method, whereas the value of other techniques still has to be defined. Also, the prophylactic use of meshes is able to reduce the incidence of parastomal hernias. With regard to short- and long-term complications, their general recommendation must be proven in further studies.

Schlüsselwörter

parastomale Hernie - Netzimplantation - Hernienreparation - Hernienrezidiv - Prävention

Key words

parastomal hernia - mesh implantation - hernia repair - hernia recurrence - prevention

Literatur

• 1 Abrams B L, Alsikafi F H, Waterman N G. Colostomy: a new look at morbidity and mortality.  Am Surg. 1979;  45 462-464
• 2 Aldridge A J, Simson J N. Erosion and perforation of colon by synthetic mesh in a recurrent paracolostomy hernia.  Hernia. 2001;  5 110-112
• 3 Allen-Mersh T G, Thomson J P. Surgical treatment of colostomy complications.  Br J Surg. 1988;  75 416-418
• 4 Allen-Mersh T G, Thomson J P. Surgical treatment of colostomy complications.  Br J Surg. 1988;  75 416-418
• 5 Baig M K, Larach J A, Chang S et al. Outcome of parastomal hernia repair with and without midline laparotomy.  Tech Coloproctol. 2006;  10 282-286
• 6 Bayer I, Kyzer S, Chaimoff C. A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia.  Surg Gynecol Obstet. 1986;  163 579-580
• 7 Bickel A, Shinkarevsky E, Eitan A. Laparoscopic repair of paracolostomy hernia.  J Laparoendosc Adv Surg Tech A. 1999;  9 353-355
• 8 Birnbaum W, Perrier P. Complications of abdominal colostomy.  Am J Surg. 1952;  83 64-67
• 9 Botet X, Boldo E, Llaurado J M. Colonic parastomal hernia repair by translocation without formal laparotomy.  Br J Surg. 1996;  83 981
• 10 Burns F J. Complications of colostomy.  Dis Colon Rectum. 1970;  13 448-450
• 11 Carne P W, Robertson G M, Frizelle F A. Parastomal hernia.  Br J Surg. 2003;  90 784-793
• 12 Cevese P G, D'Amico D F, Biasiato R et al. Peristomal hernia following end-colostomy: a conservative approach.  Ital J Surg Sci. 1984;  14 207-209
• 13 Cheung M T. Complications of an abdominal stoma: an analysis of 322 stomas.  Aust N Z J Surg. 1995;  65 808-811
• 14 de Ruiter P, Bijnen A B. Successful local repair of paracolostomy hernia with a newly developed prosthetic device.  Int J Colorectal Dis. 1992;  7 132-134
• 15 Deol Z K, Shayani V. Laparoscopic parastomal hernia repair.  Arch Surg. 2003;  138 203-205
• 16 Edwards D P, Leppington-Clarke A, Sexton R et al. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial.  Br J Surg. 2001;  88 360-363
• 17 Gogenur I, Mortensen J, Harvald T et al. Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation.  Dis Colon Rectum. 2006;  49 1131-1135
• 18 Gould J C, Ellison E C. Laparoscopic parastomal hernia repair.  Surg Laparosc Endosc Percutan Tech. 2003;  13 51-54
• 19 Horgan K, Hughes L E. Para-ileostomy hernia: failure of a local repair technique.  Br J Surg. 1986;  73 439-440
• 20 Israelsson L A. Preventing and treating parastomal hernia.  World J Surg. 2005;  29 1086-1089
• 21 Janes A, Cengiz Y, Israelsson L A. Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia.  Br J Surg. 2004;  91 280-282
• 22 Kald A, Landin S, Masreliez C et al. Mesh repair of parastomal hernias: new aspects of the Onlay technique.  Tech Coloproctol. 2001;  5 169-171
• 23 Kasperk R, Klinge U, Schumpelick V. The repair of large parastomal hernias using a midline approach and a prosthetic mesh in the sublay position.  Am J Surg. 2000;  179 186-188
• 24 Kasperk R, Willis S, Klinge U et al. Update Narbenhernie. Parastomale Hernie.  Chirurg. 2002;  73 895-898
• 25 Köhler L. Parastomale Hernie-Technik und Ergebnisse.  Zentralbl Chir. 1997;  122 889-892
• 26 LeBlanc K A, Bellanger D E, Whitaker J M et al. Laparoscopic parastomal hernia repair.  Hernia. 2005;  9 140-144
• 27 Leslie D. The parastomal hernia.  Surg Clin North Am. 1984;  64 407-415
• 28 Londono-Schimmer E E, Leong A P, Phillips R K. Life table analysis of stomal complications following colostomy.  Dis Colon Rectum. 1994;  37 916-920
• 29 Marimuthu K, Vijayasekar C, Ghosh D et al. Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study.  Colorectal Dis. 2006;  8 672-675
• 30 Martin L, Foster G. Parastomal hernia.  Ann R Coll Surg Engl. 1996;  78 81-84
• 31 Morris-Stiff G J, Hughes L E. The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience.  J Am Coll Surg. 1998;  186 352-367
• 32 Nagy A, Kovacs T, Bognar J et al. Parastomal hernia repair and prevention with PHSL type mesh after abdomino-perineal rectum extirpation.  Zentralbl Chir. 2004;  129 149-152
• 33 Ortiz H, Sara M J, Armendariz P et al. Does the frequency of paracolostomy hernias depend on the position of the colostomy in the abdominal wall?.  Int J Colorectal Dis. 1994;  9 65-67
• 34 Pearl R K. Parastomal hernias.  World J Surg. 1989;  13 569-572
• 35 Pearl R K, Prasad M L, Orsay C P et al. Early local complications from intestinal stomas.  Arch Surg. 1985;  120 1145-1147
• 36 Rosin J D, Bonardi R A. Paracolostomy hernie repair with Marlex mesh: a new technique.  Dis Colon Rectum. 1977;  20 (4) 299-302
• 37 Rubin M S, Schoetz Jr D J, Matthews J B. Parastomal hernia. Is stoma relocation superior to fascial repair?.  Arch Surg. 1994;  129 413-418
• 38 Safadi B. Laparoscopic repair of parastomal hernias: early results.  Surg Endosc. 2004;  18 676-680
• 39 Sjodahl R, Anderberg B, Bolin T. Parastomal hernia in relation to site of the abdominal stoma.  Br J Surg. 1988;  75 339-341
• 40 Stelzner S, Hellmich G, Ludwig K. Sugerbaker technique in para-colostomy hernia. An analysis of personal experiences.  Zentralbl Chir. 1999;  124 Suppl 2 13-17
• 41 Sugarbaker P H. Peritoneal approach to prosthetic mesh repair of paraostomy hernias.  Ann Surg. 1985;  201 344-346
• 42 Turnbull R B, Weakley F L. An atlas of intestinal stomas. St. Louis: Mosby; 1967: 78–91
• 43 Williams J G, Etherington R, Hayward M W et al. Paraileostomy hernia: a clinical and radiological study.  Br J Surg. 1990;  77 1355-1357