医学
切口疝
外科
回肠造口术
聚己二酮
疝
纤维接头
随机对照试验
外科手术网
作者
Carles Olona,Aleidis Caro,Ricard Sales,Cristina Ballesteros Ruiz,Carla Gonçalves,Raquel Casanova,Rosa Jorba
标识
DOI:10.1093/bjs/znad080.151
摘要
Abstract Aim The primary aim of the study is to determine the efficacy of the placement of an onlay mesh for prevention of incisional hernia after loop ileostomy closure Material & Methods This is a multicentric, prospective, randomized controlled trial including patients operated on for loop ileostomy closure after a prior rectal resection for rectal cancer. In the control group (C), after the digestive tract is reconstructed, the closure of the abdominal wall is performed by a 4:1 ratio running suture of polydioxanone. Patients in the study group (M) had the same closure procedure performed, and a light polypropilene mesh is placed onlay. The presence of incisional hernia was evaluated by physical examination at scheduled clinical visits and radiologically by an abdominal CT scan performed at the end of follow-up (6 month after surgery) Results 58 patients were included (27 in control group and 31 in mesh group) . Both groups had similar characteristics, except for a higher rate of smokers in the control group (48% vs 6%). During the follow-up, 5% of patients developed an incisional hernia (Group M 0 vs Group C 11%). At 30 days of follow-up 5 (16%) surgical site occurrences were detected in Group M for 4 (15%) in Group C. Conclusions A low incidence of IH after ileostomy closure is detected. All the IH were presented in the control group with no stadistically significant differences between groups. Larger trials with longer follow-up are needed to confirm the results.
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