Täckström Staffan, Angenete Eva, Grönkvist Rode, Haglind Eva, Kälebo Peter, Correa Marinez Adiela, Rosenberg Jacob, Nikberg Maziar
Department of Radiology, Västmanlands Hospital Västerås, Västerås, Sweden.
Centre for Clinical Research of Uppsala University, Västerås, Sweden.
Hernia. 2025 Apr 28;29(1):151. doi: 10.1007/s10029-025-03309-8.
The primary aim of this study was to investigate whether rectus abdominis muscle atrophy is associated with a lower risk of developing parastomal hernia. Secondary objectives were to assess whether the use of prophylactic mesh is a risk factor for rectus abdominis muscle atrophy and whether the position of the stoma within the rectus abdominis muscle affects the risk of parastomal hernia.
This retrospective study analysed patients from a prospective, randomised, multicentre trial in which rectal cancer patients were randomised to stoma creation with or without prophylactic mesh. Computed tomography at 12 months was evaluated to identify parastomal hernia, rectus abdominis muscle atrophy and position of stoma in the rectus abdominis muscle.
Out of 149 patients, rectus abdominis muscle atrophy was observed in 9% and parastomal hernia in 42% of patients. There was no association between rectus abdominis muscle atrophy and parastomal hernia (p = 0.80; RR 1.07; CI 0.62-1.86), nor between prophylactic mesh and rectus abdominis muscle atrophy (p = 0.19; RR 2.00; CI 0.7-5.73). Stoma placement within the rectus abdominis muscle also showed no association with parastomal hernia development (p = 0.69; RR 0.97; CI 0.81-1.15).
This study found no statistically significant association between rectus abdominis muscle atrophy and parastomal hernia. The use of prophylactic mesh was not a risk factor for rectus abdominis muscle atrophy, and stoma placement within the rectus abdominis muscle was not associated with parastomal hernia. The previously reported association between prophylactic mesh, rectus abdominis muscle atrophy, and parastomal hernia was not confirmed in this cohort.
本研究的主要目的是调查腹直肌萎缩是否与造口旁疝发生风险较低相关。次要目标是评估预防性补片的使用是否为腹直肌萎缩的危险因素，以及造口在腹直肌内的位置是否影响造口旁疝风险。
这项回顾性研究分析了来自一项前瞻性、随机、多中心试验的患者，在该试验中，直肠癌患者被随机分为造口时使用或不使用预防性补片。对12个月时的计算机断层扫描进行评估，以确定造口旁疝、腹直肌萎缩以及造口在腹直肌内的位置。
在149例患者中，9%的患者观察到腹直肌萎缩，42%的患者发生造口旁疝。腹直肌萎缩与造口旁疝之间无关联（p = 0.80；相对危险度1.07；可信区间0.62 - 1.86），预防性补片与腹直肌萎缩之间也无关联（p = 0.19；相对危险度2.00；可信区间0.7 - 5.73）。造口置于腹直肌内与造口旁疝的发生也无关联（p = 0.69；相对危险度0.97；可信区间0.81 - 1.15）。
本研究发现腹直肌萎缩与造口旁疝之间无统计学显著关联。预防性补片的使用不是腹直肌萎缩的危险因素，造口置于腹直肌内与造口旁疝无关。该队列未证实先前报道的预防性补片、腹直肌萎缩和造口旁疝之间的关联。
