Operative Versorgung und Strategien zur Prophylaxe parastomaler Hernien

Zusammenfassung

Trotz der Weiterentwicklung operativer Techniken bleibt die parastomale Hernie eine chirurgische Herausforderung. Durch die Einführung der Netzplastiken konnten die Rezidivraten gesenkt werden. Die Therapie parastomaler Hernien stellt jedoch weiterhin ein relevantes klinisches Problem dar. Unter den differenten Netzverfahren hat sich die retromuskuläre Netzplastik etabliert, der Stellenwert anderer Verfahren ist bislang nicht abschließend zu beurteilen. Aufgrund der problematischen Versorgung kommt der Primärprophylaxe mit Netzimplantation eine besondere Bedeutung zu. Ihre grundsätzliche Anwendung muss jedoch angesichts möglicher kurz- und langfristiger Risiken in weiteren Studien geprüft werden.

Abstract

Despite the progress concerning operative techniques, parastomal hernias remain a surgical challenge. The high risk for recurrence demands precise indications for operative repair. Mesh implants reduce the recurrence rate. Among such procedures, the retromuscular mesh augmentation represents an established method, whereas the value of other techniques still has to be defined. Also, the prophylactic use of meshes is able to reduce the incidence of parastomal hernias. With regard to short- and long-term complications, their general recommendation must be proven in further studies.

parastomale Hernie - Netzimplantation - Hernienreparation - Hernienrezidiv - Prävention

parastomal hernia - mesh implantation - hernia repair - hernia recurrence - prevention

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