Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST®)
Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST®)
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DOI：
10.1007/s10029-007-0318-0
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发表时间：
2008-06-01
期刊：
影响因子：
2.3
通讯作者：
Berger, D.
中科院分区：
文献类型：
--
作者：
Berger, D.
造口术周围疝是非常常见的并发症，超过50%。只有少数研究处理预防性使用补片，以防止造口旁疝显示有希望的结果。患者和方法22例接受永久性结肠造口手术的选择性直肠手术患者（1例为回肠造口术，2例为先前存在的结肠造口手术矫正）被纳入前瞻性研究。采用腹腔内嵌片技术预防性植入一种由聚偏二氟乙烯制成的具有中心整体和漏斗状凸起的特殊设计的网状物（Dynamesh IPST (R)）。随访时间中位数为11个月（范围2-19个月），每3个月进行一次临床检查。结果无感染及其他不良反应，临床未发现造口旁疝或造口突出。12例患者在6个月后进行了常规计算机断层扫描，也排除了任何疝气形成。结论预防性使用Dynamesh IPST (R)是一种安全有效的方法，至少在短期内可以预防造口并发症，如疝形成或脱垂。
Background Hernias around ostomies are a very common complication, exceeding 50%. Only a few studies deal with the prophylactic use of mesh to prevent parastomal hernia revealing promising results.Patients and methods Twenty-two patients undergoing elective rectal surgery with a permanent colostomy-one with an ileostomy and two needing surgical correction of a preexisting colostomy-were enrolled in a prospective study. A specially designed mesh made of polyvinylidene fluoride with a central whole and a funnel arising (Dynamesh IPST (R)) was prophylactically implanted using an intraperitoneal onlay technique. The patients were followed for a median of 11 (range 2-19) months by clinical examination every 3 months.Results No infection or any other adverse effect was observed, and no parastomal hernia or stoma protrusion could be detected clinically. Twelve patients had a routine computed tomography after 6 months, which also excluded any hernia formation.Conclusion The prophylactic use of Dynamesh IPST (R) is a safe and effective procedure preventing stoma complications such as hernia formation or prolapse, at least in the short run.