Stapled Mesh Reinforcement Technique for cases with parastomal hernias; a controlled prospective pilot study

Background: Parastomal hernia is a common complication for fecal diversion that is well correlated with duration due to progressive widening of the stoma aperture and peristomal muscle weakness. The aim of the study was to re-explore the Stapled Mesh-assisted Reinforcement Technique (SMART)of parastomal hernias for implementation on a wider scale.Method: Twenty (20) patients with permanent end stomas and symptomatic parastomal hernia, were recruited for the modified SMART repair of their hernias and the perioperative outcomes were compared to the last 20 correlated patients in our Database undergoing direct hernia repair with onlay mesh using the key-hole technique, as regard operative time, logistic feasibility, time needed for stoma functioning, local wound complications, stoma complications (necrosis, retraction and prolapse) and hernia recurrence over a postoperative period of one month.Results: Apart from the shorter operative time (about 20 min) in favor for the study group, there was no statistically significant difference as regard local wound and stoma complications between both groups during the early postoperative period.Conclusion: SMART is feasible and promising in cases of symptomatic parastomal hernias.