Combination of Altemeier’s Procedure and the Laparoscopic Sugarbaker Modified Technique to Repair End Colostomy Prolapse (ECP) and Parastomal Hernia (PSH)

Introduction: Stoma Prolapse and Parastomal Incisional Hernia are both, separately, very common complications after end colostomies. However, their simultaneous occurrence is rare and, to our knowledge, combining Altemeier’s procedure and Laparoscopic Sugarbaker modified technique has yet to be reported for an end colostomy related complications. Materials & methods: In this case report, we detailed a 61 year-old morbidly obese man who suffered from a prolapsed End Colostomy, 1.5years post APR, associated to a Parastomal Incisional Hernia. The patient underwent a combination of the Altemeier’s technique of mucosal and colic resection, external closure of the defect, followed by a laparoscopic Sugarbaker modified technique using a specific Parastomal Parietex composite® mesh for reinforcement. Recovery was uneventful. Discussion: Several techniques are reported in the literature to treat separately these types of related colostomy complications but unfortunately there are no standardized guidelines for the tailored surgical treatment. Conclusion: The aim of this case report is to highlight the existence of this rare association, and its successful combined surgical treatment.