Marimuthu K, Vijayasekar C, Ghosh D, Mathew G
George Eliot Hospital, Nuneaton, UK.
Colorectal Dis. 2006 Oct;8(8):672-5. doi: 10.1111/j.1463-1318.2006.00996.x.
Parastomal hernia is a common complication after stoma formation. The objective of the study was to see whether placing prophylactic preperitoneal mesh could reduce the incidence of parastomal hernia.
Patients having elective bowel surgery requiring permanent stoma were included in this study. The time required for mesh insertion, day of stoma function, and early complications were recorded. Follow up was at 6 weeks, 3-monthly for the first year and at 6-monthly intervals thereafter.
Eighteen patients fulfilled the inclusion criteria and were followed up for 6-28 months (mean 16.05). The time taken for mesh placement was 12-22 min (mean 14). One patient had to have revision surgery on day 1 for stomal necrosis - the mesh was left in situ in that instance. This patient developed superficial laparotomy wound infection. During the follow up, no patients developed parastomal hernia, stomal prolapse, stenosis, retraction, fistula or obstruction.
The early results, in this group of patients, show that prophylactic polypropylene mesh insertion at the time of permanent stoma formation is encouraging and long-term results are awaited.
造口旁疝是造口形成后的常见并发症。本研究的目的是观察放置预防性腹膜前补片是否能降低造口旁疝的发生率。
本研究纳入了需要进行永久性造口的择期肠道手术患者。记录补片置入所需时间、造口功能恢复日期及早期并发症。随访时间为6周，第一年每3个月随访一次，此后每6个月随访一次。
18例患者符合纳入标准，随访6 - 28个月（平均16.05个月）。补片放置时间为12 - 22分钟（平均14分钟）。1例患者在术后第1天因造口坏死接受了修复手术，该例中补片留在原位。该患者发生了浅表剖腹手术切口感染。在随访期间，没有患者发生造口旁疝、造口脱垂、狭窄、回缩、瘘管或梗阻。
在这组患者中的早期结果表明，在永久性造口形成时置入预防性聚丙烯补片的效果令人鼓舞，有待观察长期结果。
