Abstract:

Objective

To evaluate the feasibility and safety of primary stoma reversal combined with giant incisional hernia repair in patients with abdominal wall giant incisional hernia and intestinal stoma， aiming to provide evidence-based guidance for clinical decision-making.

Methods

A retrospective analysis was conducted on the clinical data of 6 patients who underwent large ventral incisional hernia repair combined with stoma reversal at the Department of Gastrointestinal Surgery/Hernia and Abdominal Wall Surgery， the First Affiliated Hospital of Zhengzhou University， between January 2023 and December 2023.The surgical strategies， short-term complications， and operative outcomes were evaluated.

Results

All 6 patients successfully underwent stoma reversal combined with abdominal wall hernia repair. The average operative time was （289.2±112.4） minutes， with an average blood loss of （65.0±49.5） ml. The average hospital stay was （10.8±2.0） days. No severe postoperative complications such as anastomotic leakage，abdominal compartment syndrome， intestinal obstruction， or mesh infection occurred. Two patients developed postoperative subcutaneous seromas， which were cured after continuous drainage. During the 12-24 months of follow-up， there were no cases of incisional hernia recurrence.

Conclusion

Under strict adherence to aseptic techniques and with appropriate selection of abdominal wall reconstruction methods， the preliminary study demonstrates that single-stage stoma reversal combined with incisional hernia repair appears to be safe and feasible. Importantly， potentially contaminated surgical sites should not be considered an absolute contraindication for simultaneous hernia repair with mesh implantation.

Key words: Giant incisional hernia, Stoma reversal, One-stage surgery, Mesh infection, Safety