Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Sunderby Research Unit, Umeå University, Umeå, Sweden.
Scand J Surg. 2020 Jun;109(2):96-101. doi: 10.1177/1457496918818984. Epub 2018 Dec 19.
Parastomal hernia is common, but there are few population-based studies showing the frequency and outcome of parastomal hernia repair in routine surgical practice. The aim of this study was to identify patients undergoing surgery for parastomal hernia in Sweden and to define risk factors for complication and recurrence.
A broad search of the Swedish National Patient Register 1998-2007 for all possible parastomal hernia repairs using surgical procedure codes. Records of all patients identified were reviewed and those with a definite parastomal hernia procedure were included and analyzed.
A total of 71 patients were identified after review of the records. The most common reason for surgery was cosmetic and the most frequent method was relocation of the stoma. Parastomal hernia recurrence rate was 18% during follow-up of a minimum 2 years. Overall, a surgical complication occurred in 32%. Possible risk factors were analyzed including emergency surgery versus planned, gender, age, indication for surgery, and method of surgery; none of which was significant.
The frequency of parastomal hernia procedures was much lower than suggested by previous studies. The number of procedures per surgeon was even lower than expected. No specific risk factor could be identified. Parastomal hernia auditing in the form of a nationwide quality register should be mandatory. Centralization should be considered.
肠造口旁疝较为常见，但很少有基于人群的研究显示在常规外科实践中肠造口旁疝修补的频率和结果。本研究的目的是在瑞典确定接受肠造口旁疝手术的患者，并确定并发症和复发的风险因素。
广泛搜索瑞典全国患者注册数据库 1998-2007 年所有可能的肠造口旁疝修补术，使用手术程序代码。对所有确定的患者记录进行回顾，并对确定有肠造口旁疝手术的患者进行分析。
在对记录进行审查后，共确定了 71 例患者。手术最常见的原因是美容，最常见的方法是重新定位造口。在至少 2 年的随访中，肠造口旁疝的复发率为 18%。总体而言，发生手术并发症的比例为 32%。分析了可能的风险因素，包括急诊手术与择期手术、性别、年龄、手术指征和手术方法；但均无显著意义。
肠造口旁疝手术的频率远低于既往研究的报道。每位外科医生的手术例数甚至低于预期。未确定特定的风险因素。肠造口旁疝的全国性质量登记应作为一种强制性的审核方式。应考虑集中化。
