• T H Lüning and E-J Spillenaar-Bilgen.
• Department of Surgery, Alysis Zorggroep, locatie Rijnstate, Arnhem, The Netherlands. T.luning@gmail.com
• Hernia. 2009 Oct 1; 13 (5): 487-90.

ObjectiveTo determine the complication and infection risks following extra-peritoneal onlay mesh placement in parastomal hernia repair.DesignA retrospective analysis of medical records was performed.BackgroundParastomal hernia is a frequent complication of enterostomata. Fascial repair using a prosthetic mesh has been generally accepted as the best method of parastomal hernia repair. New studies suggest the use of a prophylactic mesh placement at the initial operation, but fear of wound infection and mesh removal is still high.Patients And MethodsA retrospective review of patient records was performed of all patients with extra-peritoneal parastomal hernia repair using a prosthetic mesh between 1997 and 2006. The patient demographic data, enterostomy indication, therapy, and outcome were recorded.ResultsIn the 10-year study period, 16 parastomal hernia repairs using an extra-peritoneal prosthetic mesh in the onlay position were performed. In one patient, a mesh infection occurred, resulting in mesh removal (6.2%). The recurrence rate was 19% after a mean follow-up of 33 months.ConclusionParastomal hernia repair using a prosthetic mesh is a safe and effective method, with the lowest recurrence rates and acceptably low infection rates. Prosthetic materials should not be used in cases of fecal contamination.

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