Article Text
Abstract
Introduction Evidence supporting the benefits of enhanced recovery after surgery (ERAS) protocols is abundant; however there is no published data on how ERAS may affect the incidence of parastomal hernias.
Method Retrospective, observational, single centre cohort study of patients who underwent elective or emergency operations with stoma formation from January 2006 until March 2013. The cohort was split into ERAS and traditional recovery, and a review of case-notes and stoma nurse records allowed identification of those who developed parastomal hernias at any time point post-operatively.
Results 208 patients were included; 95 underwent a traditional recovery, and 113 underwent ERAS. The demographics of these 2 groups were comparable. 14.74% non-ERAS patients (n = 14) developed parastomal hernias compared to 34.51% (n = 39) in the Enhanced Recovery group (p = 0.0011).
Conclusion This study demonstrated a significantly increased incidence of parastomal hernias in those undergoing enhanced recovery, consistent with the earlier postoperative mobilisation. While the other benefits of ERAS outweigh this risk, this reality of modern post-operative care should reinvigorate the use of scrupulous surgical technique, and consideration of stoma site reinforcement options.
Disclosure of interest None Declared.
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