PERISTOAAAL HERNIA; THE IDEAL MANAGEMENT

Aim: Peristomal hernia is a distressing complication of intestinal stomas that is mostly due to one or more technical errors. In this study, stoma repositioning within rectus sheath will be evaluated as a line of treatment. Methods: Thirteen patients (8 females and 5 males) were operated upon two to five years after operations of abdominoperineal resection of malignant lesions of the lower rectum with terminal left pelvic colostomy who developed peristomal hernias. The colon was prepared and under general anaesthesia, an elliptical incision was done around the stoma, hernia was reduced, the sac excised, stoma was freed and new stoma site was created through rectus sheath. Parastomal hernias were dealt with through laparotomy if associated with incisional hernia. Peristomal hernia defect was closed using prolene mesh in an inlay mariner. Results: There was no intraoperative complications. Postoperative complications included delayed colostomy function in 5 cases, seroma formation in 5 cases and infected seroma in 2 cases. The patients were convenient with the newly designed stoma, which was cosmetically better and functionally good Conclusion: Peristomal hernia is one of avoidable hernias. Stoma repositioning within the rectus sheath is one of the most suitable lines of treatment of peristomal hernia