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结肠造口术中预防性应用补片预防造口旁疝：一项Meta分析

Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis.

作者信息

Zhu JunJia, Pu YuWei, Yang XiaoDong, Zhang DeBao, Zhao Kui, Peng Wei, Xing ChunGen

机构信息

Department of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, China.

出版信息

Gastroenterol Res Pract. 2016;2016:1694265. doi: 10.1155/2016/1694265. Epub 2016 Oct 12.

DOI:10.1155/2016/1694265
PMID:27818679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5080498/
Abstract

. Parastomal hernia is a common complication after stoma formation, especially in permanent colostomy. The present meta-analysis aimed to evaluate the effectiveness of prophylactic mesh application during permanent colostomy for preventing parastomal hernia. Randomized controlled trials comparing outcomes in patients who underwent colostomy with or without prophylactic mesh application were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Libraries. This meta-analysis included 8 randomized controlled trials with 522 participants. Our pooled results showed that prophylactic mesh application (mesh group) reduced the incidence of clinically detected parastomal hernia (risk ratio [RR]: 0.22; 95% confidence interval [CI]: 0.13-0.38; < 0.00001), radiologically detected parastomal hernia (RR: 0.62; 95% CI: 0.47-0.82; = 0.0008), and surgical repair for herniation (RR: 0.34; 95% CI: 0.14-0.83; = 0.02) when compared with conventional permanent colostomy formation (control group). The incidence of complications, including wound infection, peristomal infection, mesh infection, stomal necrosis and stenosis, stoma site pain, and fistula, was not higher in the mesh group than in the control group. Our meta-analysis demonstrated that prophylactic mesh application at the time of primary colostomy formation is a promising method for the prevention of parastomal herniation.

摘要

造口旁疝是造口形成后的常见并发症，尤其是在永久性结肠造口术中。本荟萃分析旨在评估永久性结肠造口术期间预防性应用补片预防造口旁疝的有效性。从PubMed、EMBASE、科学引文索引和Cochrane图书馆中检索了比较接受或未接受预防性补片应用的结肠造口术患者结局的随机对照试验。本荟萃分析纳入了8项随机对照试验，共522名参与者。我们的汇总结果显示，与传统永久性结肠造口术形成（对照组）相比，预防性应用补片（补片组）降低了临床检测到的造口旁疝的发生率（风险比[RR]：0.22；95%置信区间[CI]：0.13 - 0.38；P < 0.00001）、放射学检测到的造口旁疝的发生率（RR：0.62；95% CI：0.47 - 0.82；P = 0.0008）以及疝修补手术的发生率（RR：0.34；95% CI：0.14 - 0.83；P = 0.02）。补片组包括伤口感染、造口周围感染、补片感染、造口坏死和狭窄、造口部位疼痛以及瘘管等并发症的发生率并不高于对照组。我们的荟萃分析表明，在初次结肠造口术形成时预防性应用补片是预防造口旁疝的一种有前景的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/1cbcd286f280/GRP2016-1694265.010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/0dc9b85bd211/GRP2016-1694265.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/b7608b265685/GRP2016-1694265.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/f52f4a9e3a14/GRP2016-1694265.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/e8dc86a7ca6f/GRP2016-1694265.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/99cad15afa29/GRP2016-1694265.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/0412d18b4364/GRP2016-1694265.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/6ca81f389577/GRP2016-1694265.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/99b40239656b/GRP2016-1694265.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/512ad509b314/GRP2016-1694265.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/1cbcd286f280/GRP2016-1694265.010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/0dc9b85bd211/GRP2016-1694265.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/b7608b265685/GRP2016-1694265.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/f52f4a9e3a14/GRP2016-1694265.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/e8dc86a7ca6f/GRP2016-1694265.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/99cad15afa29/GRP2016-1694265.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/0412d18b4364/GRP2016-1694265.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/6ca81f389577/GRP2016-1694265.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/99b40239656b/GRP2016-1694265.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/512ad509b314/GRP2016-1694265.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a02/5080498/1cbcd286f280/GRP2016-1694265.010.jpg

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