TY  - CHAP
M1  - Book, Section
TI  - Parastomal Hernia Repair, Laparoscopic
A1  - Ellison, E. Christopher
A1  - Zollinger, Jr., Robert M.
A1  - Pawlik, Timothy M.
A1  - Vaccaro, Patrick S.
A1  - Bitans, Marita
A1  - Baker, Anthony S.
PY  - 2022
T2  - Zollinger’s Atlas of Surgical Operations, 11e
AB  - Parastomal  hernia  is  the  most  common  late  complication  after  stoma  creation.  In  fact,  given  enough  time,  almost  all  stomas  will  develop  some  degree  of  herniation  through  the  abdominal  wall  opening.  In  addition  to  the  prevalent  nature  of  parastomal  hernias,  attempts  at  repair  are  often  followed  by  very  high  recurrence  rates  approaching  60%–70%  in  some  series.  Given  this  extraordinary  risk  of  failure,  the  mere  presence  of  a  parastomal  hernia  should  not  be  considered  an  indication  for  repair.  Therefore,  the  initial  approach  should  always  include  commonsense  measures  such  as  weight  reduction  and  smoking  cessation.  A  trial  of  a  commercially  available  ostomy  hernia  belt,  custom-fitted  girdles,  and  other  external  support  accessories  is  strongly  encouraged.  A  consultation  with  a  trained  enterostomal  therapy  nurse  plays  an  invaluable  role  during  a  trial  of  these  nonoperative  measures.  Parastomal  hernia  repairs  should  only  be  offered  to  patients  exhibiting  significant  pain  or  recurrent  bowel  obstructions  and  those  who  have  failed  a  trial  of  external  support  devices.  Another  common  indication  for  stoma  repair  is  difficulty  with  maintaining  a  seal  around  the  stoma  and  other  pouching  problems  caused  by  the  deformed  abdominal  wall.  Of  course,  like  a  hernia  at  any  other  location,  an  incarcerated  parastomal  hernia  constitutes  an  absolute  indication  for  surgical  intervention.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/25
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1187821578
ER  -