Division of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, 55905, USA.
School of General Surgery, Alma Mater Studiorum Università di Bologna, Bologna, Italy.
Hernia. 2024 Dec;28(6):2245-2253. doi: 10.1007/s10029-024-03153-2. Epub 2024 Sep 6.
To describe and evaluate safety and feasibility of the robotic modified Sugarbaker technique with intraperitoneal underlay mesh (IPUM) for repairing parastomal hernias associated with ileal conduits (ICPSH).
This retrospective, single-center cohort study analyzed data from 15 adult patients who underwent robotic ICPSH repair using the modified Sugarbaker IPUM technique between July 2021 and July 2023. The primary endpoints were hernia recurrence rates and 30-day morbidity. Secondary endpoints included length of stay, conversion to open surgery, 30-day readmission, and 30-day reoperation.
The mean patient age was 69.1 years, and 53.3% were female. Most patients (86.6%) had undergone radical cystectomy as the index surgery. The mean operative time was 249 min, with no conversions to open surgery. The 30-day complication rate was 26.7%, and the mean hospital stay was 3.6 days. No hernia recurrences, hydronephrosis, rise in creatinine or distended conduit on imaging suggesting poor drainage were observed during a mean follow-up of 15.2 months.
The robotic modified Sugarbaker IPUM technique appears safe and feasible for PSH repair in IC patients, with promising short-term outcomes. Further studies with larger cohorts and longer follow-up are needed to confirm its long-term efficacy and establish its role in ICPSH management.
描述并评估机器人改良 Sugarbaker 技术联合腹腔内衬垫补片（IPUM）治疗与回肠造口相关的旁正中疝（ICPSH）的安全性和可行性。
这是一项回顾性、单中心队列研究，分析了 2021 年 7 月至 2023 年 7 月期间，15 例成人患者接受机器人改良 Sugarbaker IPUM 技术治疗 ICPSH 的数据。主要终点是疝复发率和 30 天发病率。次要终点包括住院时间、中转开腹率、30 天再入院率和 30 天再次手术率。
患者平均年龄为 69.1 岁，53.3%为女性。大多数患者（86.6%）曾因膀胱癌行根治性膀胱切除术作为指数手术。手术平均时间为 249 分钟，无中转开腹手术。30 天并发症发生率为 26.7%，平均住院时间为 3.6 天。在平均 15.2 个月的随访期间，未观察到疝复发、肾积水、肌酐升高或影像学上显示造口引流不良的扩张造口。
机器人改良 Sugarbaker IPUM 技术似乎是治疗 IC 患者 PSH 的一种安全且可行的方法，具有良好的短期效果。需要进一步开展具有更大样本量和更长随访时间的研究，以证实其长期疗效，并确定其在 ICPSH 管理中的作用。
