Parastomal hernia repair
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Benign Disease- A 65-year-old man with a history of rectal cancer underwent abdominoperineal resection 10 years ago. He presents with a large, symptomatic parastomal hernia. Which technique has the lowest recurrence rate?
- A 65-year-old woman with coronary artery disease and a history of abdominoperineal resection for a low rectal cancer 3 years ago presents with a painless peristomal bulge and an occasional appliance leak. She denies pain and reports normal colostomy output. Examination reveals a pink healthy colostomy and soft bulge medial to the stoma on application of the Valsalva maneuver. Result of recent surveillance computed tomography is available for review (Figure). What is the best management option?
- You operate on a 23-year-old man who sustained multiple stab wounds to the abdomen. His injuries include a grade II splenic hematoma and a sigmoid colon laceration involving 40% of the colonic wall. The perisigmoid mesentery is intact. He has received 3 units of blood in the operating room. What is your recommendation for repair of his colonic injury?