To evaluate the feasibility and efficacy of preperitoneal mesh reinforcement combined with the Lap-re-Do Sugarbaker or Keyhole technique for parastomal hernia repair and stoma reconstruction.

This was a retrospective descriptive study. A retrospective analysis was conducted on the clinical data of 8 patients who underwent tension-free parastomal hernia repair with preperitoneal mesh placement and Lap-re-Do Sugarbaker/Keyhole at West China Hospital, Sichuan University between July 2020 and July 2022. All enrolled patients had concurrent conditions including intra-abdominal contamination, poor stoma construction, and intra-abdominal adhesions. Patient demographics, operative details, and length of hospital stay were analyzed, and postoperative complications were recorded during follow-up.

All patients successfully completed the planned procedure. Operative time ranged from 162 to 620 minutes, with a mean of (454.63±113.38) minutes; Median hernia sac size (length×width) was 8.38 (5.00, 10.00) cm×7.63 (4.00, 8.50) cm; Hernial ring diameter: 7-15 cm (mean 9.50±2.88 cm); Postoperative hospitalization: 7-41 days (mean 18.25±9.06 days). During the 2-year follow-up, no parastomal hernia recurrence was observed. One patient (1/8) required readmission for localized wound infection, which resolved after 20 days of negative-pressure wound therapy and anti-infection treatments.

With strict inclusion criteria, for high-risk patients undergoing tension-free parastomal hernia repair with concomitant abdominal cavity contamination, poor stoma quality, or intra-abdominal adhesions, mesh placement in the preperitoneal space is safe and effective. It can reinforce abdominal wall strength, and may potentially reduce the occurrence of postoperative complications such as infection and intra-abdominal adhesions.