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Surgical Methods for Minimizing the Incidence of Paracolostomy Hernias

Tsvetan Popov, Vasil Pavlov, Angel Arabadzhiev, Monika Momchilova, Aysun Mehmed, Manol Sokolov, Svilen Maslyankov


INTRODUCTION: Regardless of the advances in surgical techniques, parastomal hernia continues to be a frequent and serious complication after colostomy construction. The outcomes after surgical treatment are often not satisfactory, and the recurrence rate is high.

AIM: The study aims to present modern surgical methods for the prevention of paracolostomy hernias.

MATERIALS AND METHODS: The study included 77 patients with formed colostomies in the Clinic of Surgery of Alexandrovska University Hospital during the period from 2017 to 2022, analyzed with a follow-up period of at least six months. Group A includes 35 patients whose stoma was constructed by the extraperitoneal route. Group B consists of 42 patients with the traditional transperitoneal technique. In addition, 2 patients in whom synthetic mesh was used to treat and prevent paracolostomy hernia are reported.

RESULTS: In group A only one patient was diagnosed with parastomal hernia, while in group B there were 9. The difference between the two groups was found to be statistically significant (p < 0.05). In the cases where a prophylactic synthetic mesh was utilized, no complications we observed.

CONCLUSION: Improving surgical techniques for preventing paracolostomy hernias is crucial, as they represent an inevitable complication, in most cases, after colostomy formation. The results of the conducted study as well as the available literature data highlight the benefits of methods such as the extraperitoneal route for stoma construction and the prophylactic use of synthetic meshes.


colostomy, parastomal, hernia, colorectal surgery

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About The Authors

Tsvetan Popov
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Vasil Pavlov
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Angel Arabadzhiev
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Monika Momchilova
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Aysun Mehmed
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Manol Sokolov
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

Svilen Maslyankov
Clinic of Surgery, Alexandrovska University Hospital, Sofia, Bulgaria

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