Incisional hernia following ileostomy closure: who's at risk? The Gold Coast experience
| Autor: | Ian Bloomfield, Benjamin Dobson, David A. Clark, Michael Von Papen |
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| Rok vydání: | 2021 |
| Předmět: |
Subset Analysis
medicine.medical_specialty Leak education.field_of_study business.industry Incisional hernia Ileostomy Gold coast Incidence (epidemiology) Population General Medicine Anastomosis Surgical Mesh medicine.disease Ghana Surgery Risk Factors medicine Humans Incisional Hernia Ileostomy closure business education Retrospective Studies |
| Zdroj: | ANZ journal of surgeryReferences. 92(1-2) |
| ISSN: | 1445-2197 |
| Popis: | Background: Diverting ileostomy is utilized to protect high-risk anastomoses, though it is not shown to reduce the leak rate it may reduce the severe consequences of an anastamotic leak. In recent years mesh development has advanced to allow placement of meshes into potentially contaminated fields, such as an ostomy closure site. Method: A retrospective review of all ileostomy closure procedures in Gold Coast from 1st January 2011 until 31st December 2018 were included. Patient demographics and surgical outcomes and follow up reviewed to identify any cases of incisional hernia relating to ostomy closure. Results: A total of 193 patients were identified, after exclusions 171 were suitable for analysis within the study, a total of 25 incisional hernia detected radiologically or clinically. Two independent risk factors were identified BMI >30 and ASA 3–4. Both had significant association with development of incisional hernia with a 3- and 2-fold RR increase, respectively. This was also reflected in a subset analysis of BMI ranges demonstrating increased risk in the obese and severely obese group. Discussion: The high-risk group in our population was elevated BMI and ASA, these are the patients we would expect to benefit the most from targeted therapy to reduce the incidence of incisional hernia. Future studies to look at whether reducing BMI or prophylactic mesh placement are effective. |
| Databáze: | OpenAIRE |
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