To evaluate the efficacy and safety of laparoscopic intraperitoneal onlay mesh repair with the keyhole technique (IPST) versus the Sugarbaker technique for the treatment of parastomal hernia.

A retrospective analysis was conducted on 31 patients with parastomal hernia following abdominoperineal resection (Miles′ operation) for rectal cancer. These patients underwent laparoscopic repair, either with the IPST (n=16, 51.6%) or the Sugarbaker technique (n=15, 48.4%), in the Second Department of General Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, between Jan. 2020 and Jun. 2023. Patient demographic data, postoperative complications, and the primary outcome-recurrence rate-were collected. Postoperative follow-up exceeded 12 months.

No mortality was recorded within 6 months postoperatively. One patient (6.7%) in the Sugarbaker group was readmitted due to postoperative fever and recovered conservatively during follow-up. The recurrence rate was 13.3%(2 cases) in the Sugarbaker group and 12.5%(2 cases) in the IPST group. Furthermore, no significant differences were observed between the IPST and Sugarbaker groups regarding intraoperative details or postoperative complications, including abdominal distension, surgical site infection, intestinal obstruction, enteric fistula, chronic postoperative pain, or recurrence.

Both the Sugarbaker and IPST techniques have been demonstrated to be effective, feasible, safe, and to yield similar clinical outcomes in the surgical management of parastomal hernia, particularly with respect to their low recurrence rates.