Jänes A, Cengiz Y, Israelsson L A
Department of Surgery, Sundsvalls sjukhus, Sundsvall, Sweden.
Br J Surg. 2004 Mar;91(3):280-2. doi: 10.1002/bjs.4417.
Parastomal hernia is a common complication following colostomy, and repair with a prosthetic mesh is associated with the lowest recurrence rate. The aim of this study was to determine the effect on stoma complications of using a mesh at the primary operation.
Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. A large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.
Twenty-seven patients were randomized to have a conventional stoma and 27 to have the mesh. No infection, fistula formation or pain occurred (observation time 2-28 months). At the 12-month follow-up, parastomal hernia was present in eight of 18 patients without a mesh and in none of 16 patients in whom the mesh was used.
A lightweight prosthetic mesh in a sublay position at the stoma site was not associated with infection or other early complications. Preliminary results indicate that the mesh prevented the development of parastomal hernia.
造口旁疝是结肠造口术后的常见并发症，使用人工合成补片修补复发率最低。本研究旨在确定在初次手术时使用补片对造口并发症的影响。
接受永久性结肠造口术的患者被随机分为两组，一组采用传统造口术，另一组在腹膜前间隙放置补片。使用的是一种大孔径、轻质的补片，其聚丙烯含量降低，可吸收材料比例高。
27例患者被随机分配接受传统造口术，27例接受补片植入。未发生感染、瘘管形成或疼痛（观察时间为2 - 28个月）。在12个月的随访中，18例未使用补片的患者中有8例出现造口旁疝，而16例使用补片的患者均未出现。
在造口部位腹膜前间隙放置轻质人工合成补片不会引起感染或其他早期并发症。初步结果表明，补片可预防造口旁疝的发生。
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