Parastomal Hernia: A Retrospective Nationwide Cohort Study Comparing Different Techniques with Long-Term Follow-Up
| Autor: | Anu Välikoski, Tero Rautio, Elisa Mäkäräinen-Uhlbäck, Maija Kalliala, Jyrki Kössi, Jaana Vironen, Pia Nordström, Aristotelis Kechagias, Anne Mattila, Pasi Ohtonen, Tuomo Rantanen, Tom Scheinin, Ville Falenius |
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| Přispěvatelé: | HUS Abdominal Center, Department of Surgery, HYKS erva, Päijät-Häme Welfare Consortium, IV kirurgian klinikka, Tampere University, Kanta-Häme Central Hospital Hämeenlinna |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Original Scientific Report Cohort Studies 03 medical and health sciences 0302 clinical medicine Recurrence Medicine Humans Incisional Hernia Hernia Finland Herniorrhaphy Retrospective Studies business.industry Surgical Stomas Retrospective cohort study Vascular surgery Surgical Mesh 3126 Surgery anesthesiology intensive care radiology medicine.disease Hernia Ventral 3. Good health Surgery Surgical mesh Cardiothoracic surgery 030220 oncology & carcinogenesis 3121 General medicine internal medicine and other clinical medicine 030211 gastroenterology & hepatology Neoplasm Recurrence Local Complication business Abdominal surgery Cohort study Follow-Up Studies |
| Zdroj: | World Journal of Surgery |
| ISSN: | 1432-2323 0364-2313 |
| Popis: | Background Parastomal hernia repair is a complex surgical procedure with high recurrence and complication rates. This retrospective nationwide cohort study presents the results of different parastomal hernia repair techniques in Finland. Methods All patients who underwent a primary end ostomy parastomal hernia repair in the nine participating hospitals during 2007–2017 were included in the study. The primary outcome measure was recurrence rate. Secondary outcomes were complications and re-operation rate. Results In total, 235 primary elective parastomal hernia repairs were performed in five university hospitals and four central hospitals in Finland during 2007–2017. The major techniques used were the Sugarbaker (38.8%), keyhole (16.3%), and sandwich techniques (15.4%). In addition, a specific intra-abdominal keyhole technique with a funnel-shaped mesh was utilized in 8.3% of the techniques; other parastomal hernia repair techniques were used in 21.3% of the cases. The median follow-up time was 39.0 months (0–146, SD 35.3). The recurrence rates after the keyhole, Sugarbaker, sandwich, specific funnel-shaped mesh, and other techniques were 35.9%, 21.5%, 13.5%, 15%, and 35.3%, respectively. The overall re-operation rate was 20.4%, while complications occurred in 26.3% of patients. Conclusion The recurrence rate after parastomal hernia repair is unacceptable in this nationwide cohort study. As PSH repair volumes are low, further multinational, randomized controlled trials and hernia registry data are needed to improve the results. |
| Databáze: | OpenAIRE |
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