Mesh infection by stomal perforation after recurrent parastomal hernia repair using the keyhole technique

Abstract

We report a case of mesh infection by stomal perforation after recurrent parastomal hernia repair using the keyhole technique. The patient was a 78-year-old woman. She underwent Miles operation for rectal cancer [stage pT3(SS)N0, M0] at the age of 66. She was given a diagnosis of parastomal hernia at the age of 71, and the hernia was repaired using a keyhole technique. However, recurrence of parastomal hernia occurred at the age of 72, and was repaired again using a similar technique. When she was 78 years old, she presented with abdominal pain and visited our hospital. Abdominal CT revealed mesh infection by stomal perforation. She began fasting and was initiated on antibiotics; drainage therapy was performed. A laparoscopic stoma was created in the transverse colon for the purpose of improving her state of nutrition. After the operation, she was given a diagnosis of a fistula from the small intestine to the parastomal abscesses. The mesh was surgically removed. The patient's postoperative course was uneventful, and she was discharged on postoperative day 43. No recurrence of abscess formation has been observed on follow-up. Thus, we should address and perform mesh removal operations quickly if mesh infections are diagnosed after parastomal hernia repair.