Analysis of recurrence and risk factors in laparoscopic sandwich technique for parastomal hernia repair

Introduction Parastomal hernias are frequent and highly recurrent. The sandwich technique is a combination of the keyhole and Sugarbaker techniques, using a double intraperitoneal mesh. The objective of this study was to assess the outcomes of the sandwich technique, specifically focusing on recurre...

Full description

Saved in:

Bibliographic Details
Published in:	Surgical endoscopy Vol. 37; no. 12; pp. 9125 - 9131
Main Authors:	Barranquero, Alberto G., Espert, Juan José, Llompart Coll, María Magdalena, Maestre González, Yolanda, Gas Ruiz, Cristina, Olsina Kissler, Jorge Juan, Villalobos Mori, Rafael
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-12-2023 Springer Nature B.V
Subjects:	Abdomen Abdominal Surgery Body mass index Defects Endoscopy Gastroenterology Gynecology Hepatology Hernias Hospitals Laparoscopy Medicine Medicine & Public Health Normal distribution Observational studies Ostomy Proctology Risk factors Surgery Surgical site infections Hernia, ventral Recurrence Surgical mesh Postoperative complications Incisional hernia
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Introduction Parastomal hernias are frequent and highly recurrent. The sandwich technique is a combination of the keyhole and Sugarbaker techniques, using a double intraperitoneal mesh. The objective of this study was to assess the outcomes of the sandwich technique, specifically focusing on recurrence rates. Materials and methods Observational retrospective study conducted in two tertiary referral centers in Catalonia, Spain. All consecutive patients who underwent parastomal hernia repair using the sandwich technique between 1st January 2016 and 31st December 2021 were included. Results A total of 38 patients underwent the laparoscopic sandwich technique for parastomal hernia repair. The overall recurrence rate was 7.9% (3/38), with a median follow-up of 39 months (IQR: 12.3–56.5). According to the EHS classification for parastomal hernia, there were 47.4% (18/38) type I defects, 10.5% (4/38) type II defects, 28.9% (11/38) type III defects, and 13.2% (5/38) type IV defects. The used mesh was predominantly TiMesh® (76.3%; 29/38), followed by DynaMesh® IPOM (23.7%; 9/38). Patients with recurrence exhibited higher rates of seroma, hematoma, surgical site infection, and one case of early recurrence attributed to mesh retraction. Consequently, postoperative complications emerged as the primary risk factor for hernia recurrence. Conclusion The sandwich technique demonstrated recurrence rates consistent with those reported in the existing literature.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0930-2794 1432-2218
DOI:	10.1007/s00464-023-10475-2