Jänes Arthur, Cengiz Yucel, Israelsson Leif A
Kirurgkliniken, Sundsvalls sjukhus, SE-851 86 Sundsvall, Sweden.
Arch Surg. 2004 Dec;139(12):1356-8. doi: 10.1001/archsurg.139.12.1356.
Parastomal hernia is a common complication following colostomy. The lowest recurrence rate has been produced when repair is with a prosthetic mesh. This study evaluated the effect on stoma complications of using a mesh during the primary operation.
Randomized clinical study.
Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. The mesh used was a large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material.
Twenty-seven patients had a conventional stoma, and in 27 patients the mesh was used. No infection, fistula formation, or pain occurred (observation time, 12-38 months). At the 12-month follow-up, parastomal hernia was present in 13 of 26 patients without a mesh and in 1 of 21 patients in whom the mesh was used.
A lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the stoma site is not associated with complications and significantly reduces the rate of parastomal hernia.
造口旁疝是结肠造口术后常见的并发症。使用人工合成补片修补时复发率最低。本研究评估了在初次手术中使用补片对造口并发症的影响。
随机临床研究。
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，另一组在造口下层放置补片。所用补片为大孔轻质补片，聚丙烯含量降低，可吸收材料比例高。
27例患者采用传统造口术，27例患者使用补片。未发生感染、瘘管形成或疼痛（观察时间为12 - 38个月）。在12个月的随访中，26例未使用补片的患者中有13例出现造口旁疝，21例使用补片的患者中有1例出现造口旁疝。
在造口部位下层放置聚丙烯含量降低、可吸收材料比例高的轻质补片不会引发并发症，且能显著降低造口旁疝的发生率。
