Parastomal hernias: the state of the problem, the possibilities of prevention and treatment at the hospital and outpatient stages

According to WHO there is an annual increase in the number of ostomy patients, whose number is 100–150 people per 100,000 population. As of 2019, there were more than 3,000 ostomy patients living in the Samara region of the Russian Federation. This leads to an increase in risk factors for complications, the most common of which is the formation of parastomal hernias. After two years or more, parastomal hernias are diagnosed in at least 50% of stomached patients andlead to a marked deterioration in the quality of life. The purpose of this review is to analyze the modern definition of the concept of parastomal hernia, epidemiology, risk factors, existing classifications, diagnostic methods, conservative and surgical treatment, as well as prevention of parastomal hernia. Currently there are no specific methods for the conservative treatment of parastomic hernias. Modern surgical methods for treating ostomy patients can be divided into three groups: stoma transposition, autogernioplasty and allogernioplasty. But there is no single choice of an algorithm for their surgical correction. Therefore, the development of new treatment methods, as well as modifications of existing ones, continues to be relevant. In the analysis of possible ways to prevent the development of parastomal hernia, the importance of focusing on this problem at all stages of medical rehabilitation has been established. During the pre-operative preparation, it is important to choose the correct location of the future stoma, as well as to determine the access to the intervention. It is necessary to appropriately approach the choice of the method of elimination and observe the principles of intestinal stoma formation, as well as to use a mesh implant. It is important to provide detailed information to the patient in the early postoperative period and to develop the number of specialized offices for stoma patients.