A keyhole approach gives a sound repair for ileal conduit parastomal hernia.

PURPOSE: The purpose of this study was to report and evaluate a laparoscopic surgical technique for the treatment of parastomal hernia (PSH) after ileal conduit urinary diversion aiming to minimize PSH recurrence and perioperative complications. METHODS: We retrospectively evaluated all patients who underwent a PSH (after ileal conduit urinary diversion) repair at Addenbrookes Hospital, Cambridge. As a surgical approach, a laparoscopic repair with mesh was utilized in all cases. Subsequently, we performed a voluntary follow-up of the patients to evaluate long-term recurrence and complication rates. In addition, we conducted a reassessment of the cross-sectional imaging available. RESULTS: Between November 2008 and December 2019, 27 patients underwent hernia repair due to a clinically significant hernia. Out of those patients, one suffered from a post-operative wound infection. In total 23 patients participated in the follow-up with a median follow-up period of 91 months. Follow-up examination revealed two cases of recurrent PSH (8.7% of patients followed up), four patients suffered from minor complications (14.8%). CONCLUSION: Repair of PSH associated with ileal conduit is particularly scarce. Our surgical approach presents the only laparoscopic case series of an effective method for treating a PSH from an ileal conduit with a low complication and recurrence rate.

[Prevention of recurrence in non-invasive bladder carcinoma. Experiences with 400 patients]. / Rezidivprophylaxe bei oberflächlichen Harnblasenkarzinomen. Erfahrungen mit 400 Patienten.

We report the results of 2 randomized cooperative studies. The aim of the first study was to find the optimal instillation interval for recurrence prophylactic treatment of superficial bladder tumors using Adriamycin. For this purpose the patients were randomized into 3 groups, with different instillation intervals of 1, 2 and 4 weeks. All patients had 12 instillations with 50 mg Adriamycin in 30 ml saline. Summarizing the results of the 3 groups, it was possible to reduce the number of recurrences to 36% in the 1st year after TUR and 46% after 2 years. Three years after TUR 52% of the patients had a recurrence. Differences between the groups existed in the percentage of recurrences after completion of the instillation therapy and furthermore in the incidence of chemocystitis. Admitted to this first study were 197 patients from July 1979 to December 1980. We started a second study in January 1981, in which we combined the first tested instillation intervals. All patients had now 3 instillations at 1 week intervals followed by 6 instillations at 2 weeks intervals thereafter they had 8 instillations, at 4 weeks intervals. With this combination the number of recurrences could be reduced even further. One year after TUR recurrence was found in 11.4% of the patients and 2 years after TUR in 21.9%. In a median follow-up time of 17 months we found 24% recurrences. Admitted to the second study were 214 patients from January 1981 to May 1983.