The Local Parastomal Hernia (LoPa) Repair: A Novel Approach to Parastomal Hernia Repair.

Abstract

<h4>Purpose</h4>Surgical repair of parastomal hernias (PH) is challenging, mainly due to high recurrence rates. The Local Parastomal repair (LoPa) is a novel technique utilizing a retromuscular synthetic mesh with an outward-facing collar. This study describes the LoPa technique and evaluates its outcomes.<h4>Methods</h4>This single-centre study retrospectively reviewed 39 consecutive patients who underwent LoPa repair for a PH between 2017 and 2021. Long-term follow-up, including physical examination and quality of life assessment, was conducted. The primary outcome was PH recurrence diagnosed clinically or by CT scan.<h4>Results</h4>For the 39 patients included, the mean age and BMI were 71 years and 27 kg/m², respectively. The most common ASA score was III (48.7%). The median length of stay was 3 days with no Clavien-Dindo ≥4 complications observed. At a median follow-up of 47 months, the overall recurrence rate was 33.3% (12/36 patients). Postoperative general health status was comparable to the Swedish general population, though recurrence was associated with more pain and anxiety.<h4>Conclusion</h4>The LoPa technique is a safe and feasible PH repair, offering low short-term morbidity and a short length of stay. It is an option for repairing isolated PH, especially in patients with comorbidities. While the 33.3% recurrence rate is a concern, it is comparable to other techniques with similar follow-up. These preliminary findings warrant validation in larger prospective trials.