Enterostomy site hernias: A clinical and computerized tomographic evaluation
Enterostomy site hernias: A clinical and computerized tomographic evaluation
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DOI：
10.1007/s10350-006-0681-4
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发表时间：
2006-10-01
影响因子：
3.9
通讯作者：
Aktan, A. Ozdemir
中科院分区：
文献类型：
--
作者：
Cingi, Asim;Cakir, Tebessum;Aktan, A. Ozdemir
目的：造口旁疝仍然是一个重要的临床问题，据报告发病率高达 50%。在使用计算机断层扫描对选定病例进行造口旁疝检测的研究中，仅进行体格检查低估了真实发生率。此外，在肠造口闭合后，造口部位仍然可能是潜在的疝出区域。在这项研究中，除了体检之外，我们还使用计算机断层扫描来确定造口旁疝和造口闭合部位疝的真实发生率。方法：我们通过体格检查和计算机断层扫描检查了肠造口和闭合肠造口部位的患者，以检测疝气、疝气内容以及与直肌的关系。确定了疝形成的危险因素，例如年龄、性别、体重指数、相关医疗问题和手术部位感染。结果：对 23 名造口患者进行评估，发现造口旁疝发生率为 52%，而加上断层扫描检查后，校正后的发生率为 78%。在第二组 23 名闭合造口患者中，尽管仅通过体格检查发现 26% 的患者存在造口部位疝气，但与计算机断层扫描相结合时，这一发生率增加至 48%。疝形成的潜在危险因素，例如体重指数、手术部位感染以及造口部位（无论是直肠旁肌还是经直肌），在本研究中并未被证明具有显着作用。结论：造口旁疝和闭合性造口切口疝发病率较高，计算机断层扫描已被证明是一种有价值的诊断工具。
Purpose: Parastomal hernia continues to be an important clinical problem with a reported incidence of up to 50 percent. In studies using computerized tomography in selected cases for detection of parastomal hernia, physical examination alone was underestimating the true incidence. Also after closure of the enterostomy, the ostomy site could still be a potential area of herniation. In this study in addition to physical examination, we used computerized tomography to determine the true incidence of parastomal hernia and ostomy closure site hernias. Methods: We examined patients with enterostomies and with closed enterostomy sites both with physical examination and computerized tomography for the detection of hernias, hernia content, and relation to rectus muscles. Risk factors for hernia formation, such as age, gender, body mass index, associated medical problems, and surgical site infections, were determined. Results: Evaluation of 23 patients with ostomies resulted in 52 percent incidence of parastomal hernia, whereas the addition of tomography examination gave a corrected incidence of 78 percent. In a second subset of 23 patients with closed ostomies, although 26 percent of the patients were found to have ostomy site hernias with physical examination alone, this incidence increased to 48 percent when combined with computerized tomography. The potential risk factors for hernia formation, such as body mass index, surgical site infection, and ostomy site whether pararectus or transrectus, were not proven to have a significant role in this study. Conclusions: Parastomal hernia and closed ostomy site incisional hernias have a high incidence, and computerized tomography has been shown to be a valuable diagnostic tool.