Departments of Colorectal Surgery, Royal Gwent Hospital, Newport, UK.
Colorectal Dis. 2012 Dec;14(12):1528-30. doi: 10.1111/j.1463-1318.2012.03039.x.
The prevalence of abdominal wall herniation at the site of a previous temporary stoma is uncertain. This cohort study investigated the frequency of radiological abnormalities at the site of a closed diverting loop ileostomy.
All patients in whom an ileostomy was raised and later closed during a 5-year period formed the study group. When colorectal cancer surveillance computed tomography (CT) was undertaken the images were scrutinized and graded as to defined anatomical abnormalities.
One hundred and seventy-nine patients had an ileostomy, of which 92 were diverting. Fifty-nine (64%) were closed at various intervals (median time to closure 6 (2-22) months and 43 underwent a surveillance CT at 1-3 (median 2) years. At 1 year an abnormality (atrophy or defect) at the site of closure was seen in 16 (37%) CT scans. These were more frequent with increasing duration of follow-up. One asymptomatic hernia was detected at 2 years but there was no deterioration in the abdominal wall at 3 years when compared with that at 2 years.
Abnormalities in the abdominal wall at the site of a closed diverting ileostomy are common but true herniation is unusual. The routine use of prophylactic mesh at ileostomy closure may be unnecessary.
腹壁疝在先前临时造口部位的发生率尚不确定。本队列研究调查了闭合并流回肠造口部位放射影像学异常的频率。
在 5 年期间，所有升举并随后关闭回肠造口的患者均纳入研究组。当进行结直肠癌症监测计算机断层扫描（CT）时，仔细检查图像并按照定义的解剖学异常进行分级。
179 例患者行回肠造口术，其中 92 例为分流术。59 例（64%）在不同时间间隔内关闭（中位关闭时间为 6（2-22）个月，43 例行 1-3 年（中位 2 年）的监测 CT。在 1 年时，16 例（37%）CT 扫描显示在关闭部位存在异常（萎缩或缺损）。随着随访时间的延长，这些异常更为常见。在 2 年时发现 1 例无症状疝，但与 2 年时相比，3 年时腹壁无恶化。
闭合并流回肠造口部位的腹壁异常很常见，但真正的疝并不常见。在闭合并流回肠造口时常规使用预防性网片可能没有必要。
