Prophylactic mesh placement of permanent stomas at index operation for colorectal cancer
| Autor: | S Yalamarthi, Richard R. W. Brady, Nicholas T. Ventham, M Jones, T Daniel, Cat Graham, BM Ward, RG Stewart |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer medicine.medical_treatment Stoma Abdominal wall Postoperative Complications Paracolostomy hernia Gastrointestinal Surgery Colostomy medicine Humans Prospective Studies Prospective cohort study Parastomal hernia Computed tomography Prolene Aged business.industry Abdominal wall defect Prophylactic mesh General Medicine Surgical Mesh medicine.disease Surgery Hernia Abdominal Radiography medicine.anatomical_structure Surgical mesh Female business Colorectal Neoplasms |
| Zdroj: | Annals of The Royal College of Surgeons of England |
| ISSN: | 1478-7083 0035-8843 |
| Popis: | INTRODUCTION Parastomal herniation occurs in 30–50% of colostomy formations. The aim of this study was to radiologically evaluate the mechanical defects at stoma sites in patients who had previously undergone a permanent colostomy with or without mesh at the index operation for colorectal cancer. METHODS A study was performed of all colorectal cancer patients (n=41) having an end colostomy between 2002 and 2010, with or without Prolene® mesh plication, with blinded evaluation of the annual follow-up staging computed tomography (CT) for stomal characteristics. The presence of parastomal hernias, volume, dimensions, grade of the parastomal hernia and abdominal wall defect size were measured by two independent radiologists, and compared with demographic and operative variables. RESULTS In those patients with radiological evidence of a parastomal hernia, Prolene® mesh plication significantly reduced the incidence of bowel containing parastomal hernias at one year following the procedure (pCONCLUSIONS Prophylactic mesh placement at the time of the index procedure reduces the diameter of abdominal wall aperture and the incidence of parastomal hernias containing bowel. Future studies should use both objective radiological as well as clinical endpoints when assessing parastomal hernia development with and without prophylactic mesh. |
| Databáze: | OpenAIRE |
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