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Incidence of Parastomal Hernia Post Cystectomy and Ileal

No. 075. Incidence of Parastomal Hernia Post Cystectomy and Ileal Conduit Formation: The Wollongong Experience. Shahbaz, S; Mollenkhopf , M ; Rindani , R ; Kovac , P; Chin, P; Skyring , T The Wollongong Hospital, South Eastern Sydney and Illawarra Area Health Service, NSW.

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Incidence of Parastomal Hernia Post Cystectomy and Ileal

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  1. No. 075 Incidence of Parastomal Hernia Post Cystectomy and Ileal Conduit Formation: The Wollongong Experience Shahbaz, S; Mollenkhopf, M;Rindani, R; Kovac, P; Chin, P; Skyring, T The Wollongong Hospital, South Eastern Sydney and Illawarra Area Health Service, NSW Introduction Parastomalhernias (PH) are a common complication of stoma formation. Incidence in the literature ranges 30 – 50%1 and is predominantly based on colorectal population. They can result in significant morbidity and once established, repair is fraught with failure and recurrence. Numerous studies suggest prophylactic placement of mesh at the time of procedure reduces incidence. Results Thirty-three patients fit the inclusion criteria. The overall rate of PH was 24% (8/33). Out of the eight patients with PH four were large but only three symptomatic. Average age at operation was similar for the hernia and non-hernia group (68 vs 70). All cases of PH were evident at the 6 months follow up. PH group were more likely to be obese (38% vs 16 %) and female (63% vs 20%) when compared to those without PH. Group Characteristics Total number - 33 . Aim The purpose of our study was to determine the incidence of PH in the urological population, the percentage that were symptomatic and evaluate possible risk factors. Methods A retrospective review was made of all patients who underwent cystectomy and ileal conduit diversion at our institution between 6 to 54 months ago. Information collected included demographics, co-morbidities, indication for cystectomy, intra-operative complications, post operative complications, incidence of parastomal hernia (clinical and CT) and associated morbidity. Post op complications / morbidity Conclusions In our group 8/33 patients undergoing cystectomy and ileal conduit developed PH, of these only 3 were symptomatic enough to require surgical repair. Prophylactic mesh placement has its own associated complications and our limited results does not support its use in the urology population. References Carne PW, Robertson GM, Frizelle FA. Parastomalhernia. Br J Surg. 2003;90:784 –93. Berger D, Bientzle M. Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients. Dis Colon Rectum. 2007;50:1668 –73. Pilgrim CHC, McIntyre R, Bailey M. Prospective Audit of Parastomal Hernia: Prevalence and Associated Comorbidites. Dis ColonRectum 2010; 53: 71–76 Wijeyekoon SP, Gurusamy K, El-Gendy K, Chan CL. Prevention of parastomal herniation with biologic/composite prosthetic mesh: a systematic review and meta-analysis of randomized controlled trials.J Am Coll Surg. 2010 Nov;211(5):637-45. Acknowledgements Kathy Mathieson, Practice Manager/Nurse, South Coast Urology, Wollongong Poster presentation sponsor

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