Parastomal hernias represent a common complication following colostomy formation with an incidence of well over 50 %.1,2 In an era of improving survival following optimal surgical and multimodal (neo)adjuvant approaches in the management of colorectal cancer, we are seeing an increasing cohort of patients entering survivorship.3 Morbidities affecting this cohort of patients in survivorship can impact both functional activities of daily living and have an overall detrimental impact on their quality of life.4 As a result, post-survivorship quality of life has become an important metric in the evaluation of cancer care delivery. In the context of increasing curative colorectal resections and resultant ostomy creations, parastomal hernias have become a significant source of morbidity that require more focused attention both in defining incidence and informing management.4 Up to 75 % of patients with parastomal hernias will eventually manifest symptoms of the hernia, the most common being pain and persistent issues with leakage and fitting ostomy bags.5 In addition to the discomfort, psychosocial disturbance, ostomy leakage and the life-threatening risks of obstruction associated with parastomal hernias, patients often incur higher costs associated with the more frequent need for ostomy appliance changes.4

Despite the high incidence, the diagnosis and management of parastomal hernias remain challenging. Whilst guidelines published by the European Hernia Society2 attempt to rectify this, they acknowledge the limitations resulting from insufficient high quality evidence.2 There is a particular dearth of evidence pertaining to best practices when it comes to surgical repair of parastomal hernias both elective and emergent. There is of yet no consensus on approach to surgery (open, laparoscopic, robotic) or on mesh usage in the repair of parastomal hernia.2

This study aims to characterise the current management of parastomal hernias in the Republic of Ireland using a closed system national database. Specifically, we aim to better define the cohort of patients undergoing parastomal hernia repairs (PHRs), identify potential poor prognostic factors and assess the burden of disease and its impact on healthcare costs. The study aims to begin a narrative around the management of parastomal hernias in Ireland and build towards developing more robust consensus guidelines.