Department of General Surgery, University of Texas Health Science Center at Houston, Houston, Texas; Department of General Surgery, Baylor College of Medicine, Houston, Texas.
Department of General Surgery, University of Texas Health Science Center at Houston, Houston, Texas.
J Surg Res. 2014 Aug;190(2):504-9. doi: 10.1016/j.jss.2014.01.046. Epub 2014 Jan 29.
The incidence of incisional hernias after stoma reversal is not well reported. The aim of this study was to systematically review the literature reporting data on incisional hernias after stoma reversal. We evaluated both the incidence of stoma site and midline incisional hernias.
A systematic review identified studies published between January 1, 1980, and December 31, 2012, reporting the incidence of incisional hernia after stoma reversal at either the stoma site or at the midline incision (in cases requiring laparotomy). Pediatric studies were excluded. Assessment of risk of bias, detection method, and essential study-specific characteristics (follow-up duration, stoma type, age, body mass index, and so forth) was done.
Sixteen studies were included in the analysis; 1613 patients had 1613 stomas formed. Fifteen studies assessed stoma site hernias and five studies assessed midline incisional hernias. The median (range) incidence of stoma site incisional hernias was 8.3% (range 0%-33.9%) and for midline incisional hernias was 44.1% (range 8.7%-58.1%). When evaluating only studies with a low risk of bias, the incidence for stoma site incisional hernias is closer to one in three and for midline incisional hernias is closer to one in two.
Stoma site and midline incisional hernias are significant clinical complications of stoma reversals. The quality of studies available is poor and heterogeneous. Future prospective randomized controlled trials or observational studies with standardized follow-up and outcome definitions/measurements are needed.
肠造口还纳术后切口疝的发病率尚不清楚。本研究旨在系统地回顾文献，以评估肠造口还纳术后切口疝的发生率，包括造口部位疝和中线切口疝。
系统检索 1980 年 1 月 1 日至 2012 年 12 月 31 日期间发表的文献，评估肠造口还纳术后造口部位疝和中线切口疝的发生率（需要剖腹术的病例）。排除儿科研究。评估偏倚风险、检测方法和特定研究的特征（随访时间、造口类型、年龄、体重指数等）。
纳入分析的 16 项研究中，共有 1613 例患者（1613 个造口）。15 项研究评估了造口部位疝，5 项研究评估了中线切口疝。造口部位切口疝的中位数（范围）发生率为 8.3%（范围 0%-33.9%），中线切口疝的发生率为 44.1%（范围 8.7%-58.1%）。当仅评估低偏倚风险的研究时，造口部位切口疝的发生率接近三分之一，中线切口疝的发生率接近二分之一。
造口部位和中线切口疝是肠造口还纳术后的严重临床并发症。现有研究的质量较差且存在异质性。需要未来前瞻性随机对照试验或具有标准化随访和结局定义/测量的观察性研究。
