| Surgical techniques for parastomal hernia repair: a systematic review of the literature. | |
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MedLine Citation:
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PMID: 22418006 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: : Parastomal hernias are a frequent complication of enterostomies that require surgical treatment in approximately half of patients. This systematic review aimed to evaluate and compare the safety and effectiveness of the surgical techniques available for parastomal hernia repair. METHODS: : Systematic review was performed in accordance with PRISMA. Assessment of methodological quality and selection of studies of parastomal hernia repair was done with a modified MINORS. Subgroups were formed for each surgical technique. Primary outcome was recurrence after at least 1-year follow-up. Secondary outcomes were mortality and postoperative morbidity. Outcomes were analyzed using weighted pooled proportions and logistic regression. RESULTS: : Thirty studies were included with the majority retrospective. Suture repair resulted in a significantly increased recurrence rate when compared with mesh repair (odds ratio [OR] 8.9, 95% confidence interval [CI] 5.2-15.1; P < 0.0001). Recurrence rates for mesh repair ranged from 6.9% to 17% and did not differ significantly. In the laparoscopic repair group, the Sugarbaker technique had less recurrences than the keyhole technique (OR 2.3, 95% CI 1.2-4.6; P = 0.016). Morbidity did not differ between techniques. The overall rate of mesh infections was low (3%, 95% CI 2) and comparable for each type of mesh repair. CONCLUSIONS: : Suture repair of parastomal hernia should be abandoned because of increased recurrence rates. The use of mesh in parastomal hernia repair significantly reduces recurrence rates and is safe with a low overall rate of mesh infection. In laparoscopic repair, the Sugarbaker technique is superior over the keyhole technique showing fewer recurrences. |
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Authors:
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Birgitta M E Hansson; Nicholas J Slater; Arjan Schouten van der Velden; Hans M M Groenewoud; Otmar R Buyne; Ignace H J T de Hingh; Rob P Bleichrodt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of surgery Volume: 255 ISSN: 1528-1140 ISO Abbreviation: Ann. Surg. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-03-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 685-95 Citation Subset: AIM; IM |
Affiliation:
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*Department of Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands Departments of †Surgery ‡Medical Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands §Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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