Is obstruction of ileal conduit after parastomal hernia repair with porcine derived tissue matrix Strattice™ a valid concern?
BAUS ePoster online library. Kocadag H.
Jun 27, 2018; 211402
Dr. Huriye Kocadag
Dr. Huriye Kocadag
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Abstract
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Introduction and Objective: Parastomal hernia occurs in 17% of patients with ileal conduit and recurrence following repair occurs in 27-50%. The introduction of the porcine derived tissue matrix Strattice™ showed promising results in colorectal practice. We have reviewed repair of ileal conduit para-stomal hernias to compare outcomes in urological practice.

Methods: We retrospectively reviewed notes of 57 patients (18 men) of mean age 56 years (range 33-78) with ileal conduits having repair of hernia with Strattice™ mesh..Data collected included type of hernia repair (incisional or parastomal) and possible mesh related complications . All repairs were performed by 4 consultant surgeons utilising conduit pull through and intra-peritoneal lateral mesh fixation to the anterior abdominal wall.

Results: Of the 57 patients included, 34 had incisional hernia repair (mean age 60 years, range 41-77, 9 men) and 23 had para-conduit stoma hernia repair (mean age 54 years, range 33-71, 6 men). Complications are detailed in
Table 1:



Conclusion: 9 (39%) of 23 patients having repair of their ileal conduit parastomal hernia with Strattice™ mesh developed obstructive complications whilst the para-stomal hernia recurred in only 6/23 (26%). The rate of obstructive complications is higher than expected and warrants further close follow-up and study in prospective series. It may be that success in para-stomal repair is at the expense of obstructive complications.
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