Concomitant enterostomy closure and ventral abdominal wall reconstruction using the Lázaro da Silva technique

Abstract

We present a small series of patients who underwent concomitant treatment of external digestive bypass (stoma) and incisional hernia, using the Lázaro da Silva technique - a special method of purely tissue repair. The rational was not to use meshes on contaminated wounds. Initially, five patients were enrolled and all were operated on by the same group. Some demographic data were recorded, but also the time interval between the making of the stoma (or the appearance of the enterocutaneous fistula). Some characteristics of the hernia and data related to surgical procedures were also pointed out. The primary outcome was to verify the rate of hernial recurrence, but also the surgical site occurrences in the first 30 days. Only one patient had superficial wound infection and in none of them was a recurrence detected. Our work raises some questions about the best approach in these more complex cases, such as dissociating or not dissociating the procedures, the use of meshes anyway, and employment of mini-invasive surgery in some steps.

Keywords

• intestinal fistula
• incisional hernia
• surgical mesh