Parastomal Hernia Repair: A Four-Year Single-Centre Experience With Elective and Emergency Outcomes

Abstract

Introduction Parastomal hernia (PSH) is a common complication following stoma formation, with surgical repair strategies including open, laparoscopic, and robotic techniques. Despite evolving operative approaches, recurrence and complication rates remain high, particularly in emergency settings. Methods We conducted a retrospective observational study of 87 patients who underwent PSH repair between 06 March 2021 and 06 March 2025 at a single UK centre. Data were extracted from the Bluespier theatre system and clinical records. Variables included patient demographics, urgency of surgery, operative approach, theatre duration, hospital stay, complications, and postoperative recurrence. Statistical comparisons were made between elective and emergency procedures, as well as between primary and recurrent repairs. Results Of the 87 patients, 42 (48.3%) were male, and the median age was 62.1 years. Most repairs were open (78.2%), with fewer laparoscopic (18.4%) and robotic (3.4%) cases. Elective surgeries accounted for 57.5%, and 23% of patients underwent repair of a previously recurrent hernia. The mean operative time was 129.5 minutes, and the mean hospital stay was 11.1 days. The overall postoperative recurrence rate was 21.8%. Recurrence rates were 22.1% for open, 25.0% for laparoscopic, and 0% for robotic repairs. Emergency cases had significantly longer hospital stays and higher complication rates compared to elective procedures (p < 0.01). Conclusion Elective PSH repair, including via minimally invasive techniques, was associated with favourable outcomes and lower recurrence. Emergency repair remains high-risk, underscoring the importance of early elective referral and optimised surgical planning.