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Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A french multi-institutional experience

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Abstract

Background

Parastomal incisional hernia (PH) is a frequent complication following the creation of an ileal conduit (IC), and it can be a significant detriment to quality of life. The aim of this study was to evaluate outcomes of PH repair following IC for urinary diversion.

Method

A multicenter retrospective study was conducted of 6 academic hospitals in France. The study’s population included patients who underwent surgical treatment for parastomal hernia following IC creation from 2013 to 2021.

Results

Fifty-one patients were included in the study. Median follow up was 15.3 months. Eighteen patients presented with a recurrence (35%), with a median time to recurrence of 11.1 months. The vast majority of PH repair was performed through an open approach (88%). With regard to technique, Keyhole was the most reported technique (46%) followed by Sugarbaker (22%) and suture only (20%). The Keyhole technique was associated with a higher risk of recurrence compared to the Sugarbaker technique (52% vs 10%, p = 0.046). Overall, there was a 7.8% rate of major complications without a statistical difference between PH repair techniques for major complications.

Conclusion

Surgical treatment of parastomal hernia following IC was associated with a high risk of recurrence. Novel surgical approaches to PH repair should be considered.

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Data Availability

Data are availlable on request.

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Acknowledgements

Member of SFCP-CH: Pr Yann Neuzillet, Dr Alexandra Masson Lecomte et Dr Juliette Cotte, Dr Julien Anract, Pr Evanguelos Xylinas et Dr Antoine Grassin ; Dr Jade Lehrer, Pr Alain Ruffion, Pr Marc Colombel, Dr Jena Francois Gillion

Author information

Authors and Affiliations

  1. Hospices Civils de Lyon, Service de Chirurgie Viscérale Et Oncologique, Hôpital Lyon Sud Pierre Bénite, Pierre-Bénite, France

    Nicolas Bel

  2. Service de Chirurgie Générale Et d’Urgences, CHU de Dijon – Université de Bourgogne, Bourgogne, France

    Pierre-Yves Blanc & Pablo Ortega Deballon

  3. Service de Chirurgie Générale Et Digestive, AP-HP, Hôpital Louis Mourier, DMU ESPRIT-GHU AP-HP, Nord-Université Paris Cité, 92700, Colombes, France

    David Moszkowicz

  4. Department of Surgery Division of Surgical Oncology, Duarte, CA, USA

    Bradford Kim

  5. Université Lyon1, Faculté de Médecine Et de Maïeutique Charles Mérieux, Oullins, France

    Delia Berrada

  6. Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Et Streinth Lab (Stress Response and Innovative Therapies), Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental Et Appliquée À La Cancérologie), Strasbourg University, 67200, Strasbourg, France

    David Liu & Benoit Romain

  7. Department of Urology, Robert Debre University Hospital, University of Reims Champagne-Ardennes, Rue Cognac Jay, 51100, Reims, France

    Delchet Ophélie

  8. Department of Digestive Surgery, University of Reims Champagne-Ardennes, Robert Debre University Hospital, Rue Cognac Jay, 51100, Reims, France

    Yohann Renard

  9. CICLY, Hôpital Lyon Sud Pierre Bénite, Université Lyon1, Et Hospices Civils de Lyon, Service de Chirurgie Viscérale Et Oncologique, Pierre-Bénite, France

    Guillaume Passot

Authors
  1. Nicolas Bel
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  2. Pierre-Yves Blanc
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  3. David Moszkowicz
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  4. Bradford Kim
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  5. Pablo Ortega Deballon
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  6. Delia Berrada
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  7. David Liu
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  8. Benoit Romain
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  11. Guillaume Passot
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Consortia

on behalf of SFCP-CH

  • Yann Neuzillet
  • , Alexandra Masson Lecomte
  • , Juliette Cotte
  • , Julien Anract
  • , Evanguelos Xylinas
  • , Antoine Grassin
  • , Jade Lehrer
  • , Alain Ruffion
  • , Marc Colombel
  •  & Jena Francois Gillion

Contributions

NB, GP wrote the manuscript, DM, POD, BR, YR, GP designed the study, DB and BK review and edited the manuscript, NB, PYB, DB, DL, OD collected data, updated the data, cleaned the data bases, and provided statistical analysis, all authors reviewed and edited the final manuscript.

Corresponding author

Correspondence to Guillaume Passot.

Ethics declarations

Competing interests

GP, POD, and YR declares consultant honorarium from BD. DM declares consultant honorarium from Gore.

Disclosure

GP, POD, and YR declares consultant honorarium from BD. DM declares consultant honorarium from Gore.

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Bel, N., Blanc, PY., Moszkowicz, D. et al. Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A french multi-institutional experience. Langenbecks Arch Surg 408, 344 (2023). https://doi.org/10.1007/s00423-023-03062-5

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