A Novel Surgical Technique for Preventing Parastomal Hernia.

Abstract

Parastomal hernia (PSH) is a frequent complication of enterostomy, often resulting from the gradual expansion of the abdominal wall aperture. This retrospective study evaluated a novel surgical technique designed to reduce PSH incidence by stabilizing aperture size over time. Patients who underwent permanent colostomies at the Department of Gastroenterology, Qingdao University Affiliated Hospital, between March 2020 and December 2023 were retrospectively reviewed. The primary outcome was PSH incidence at follow-up. The secondary outcome was the change in the maximum abdominal wall aperture diameter, measured by imaging at multiple time points. Ninety-two patients were included: 42 underwent the novel purse-string suture technique, and 50 received the conventional approach. Baseline characteristics and surgical outcomes were comparable. The novel group had a significantly lower PSH incidence (2.3% vs. 32%, p = 0.001). In the conventional group, the aperture diameter significantly increased from 6 to 24 months (29.5 ± 3.2 mm, 33.9 ± 3.9 mm, 35.4 ± 4.0 mm, and 36.7 ± 4.5 mm; p = 0.025, 0.039, and 0.046, respectively). In contrast, the novel group maintained stable aperture diameters throughout follow-up. The novel technique appears to effectively prevent PSH by maintaining a consistent aperture size. This simple and safe method shows promising results, though further multicenter studies are needed to validate these findings.