{"title":"同时治疗复杂切口疝和造口翻转术","authors":"Carles Olona, Ricard Sales, Aleidis Caro-Tarragó, Beatriz Espina, Raquel Casanova, Rosa Jorba","doi":"10.3389/jaws.2023.11093","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> The simultaneous repair of incisional hernias (IH) and the reconstruction of the intestinal transit may pose a challenge for many surgeons. Collaboration between units specialized in abdominal wall and colorectal surgery can favor simultaneous treatment. <b>Methods:</b> Descriptive study of patients undergoing simultaneous surgery of complex IH repair and intestinal transit reconstruction from the start of treatment in a joint team. All interventions were performed electively and with the collaboration of surgeons experts in abdominal wall and colorectal surgery. <b>Results:</b> 23 patients are included. 11 end colostomies, 1 loop colostomy, 6 end ileostomies and 5 loop ileostomies. Seven (30%) patients presented with a medial laparotomy incisional hernia, 3 (13%) with a parastomal incisional hernia, and 13 (56%) with a medial and parastomal incisional hernia. Closure of the hernial defect was achieved in 100% of cases, and reconstruction of the intestinal tract was achieved in 22 (95%). Component separation was required in 17 patients (74%), which were 11 (48%) posterior and 6 (26%) anterior. In-hospital morbidity was 9%, and only two patients presented Clavien-Dindo morbidity > III when requiring reoperation, one due to hemorrhage of the surgical bed and another due to dehiscence of the coloproctostomy. The mean follow-up was 11 months, with 20 (87%) patients having no complications. Mesh had to be removed in one patient with anastomotic dehiscence, no mesh had to be removed due to surgical site infection.</p>","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10831652/pdf/","citationCount":"0","resultStr":"{\"title\":\"Simultaneous Treatment of Complex Incisional Hernia and Stoma Reversal.\",\"authors\":\"Carles Olona, Ricard Sales, Aleidis Caro-Tarragó, Beatriz Espina, Raquel Casanova, Rosa Jorba\",\"doi\":\"10.3389/jaws.2023.11093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Purpose:</b> The simultaneous repair of incisional hernias (IH) and the reconstruction of the intestinal transit may pose a challenge for many surgeons. Collaboration between units specialized in abdominal wall and colorectal surgery can favor simultaneous treatment. <b>Methods:</b> Descriptive study of patients undergoing simultaneous surgery of complex IH repair and intestinal transit reconstruction from the start of treatment in a joint team. All interventions were performed electively and with the collaboration of surgeons experts in abdominal wall and colorectal surgery. <b>Results:</b> 23 patients are included. 11 end colostomies, 1 loop colostomy, 6 end ileostomies and 5 loop ileostomies. Seven (30%) patients presented with a medial laparotomy incisional hernia, 3 (13%) with a parastomal incisional hernia, and 13 (56%) with a medial and parastomal incisional hernia. Closure of the hernial defect was achieved in 100% of cases, and reconstruction of the intestinal tract was achieved in 22 (95%). Component separation was required in 17 patients (74%), which were 11 (48%) posterior and 6 (26%) anterior. In-hospital morbidity was 9%, and only two patients presented Clavien-Dindo morbidity > III when requiring reoperation, one due to hemorrhage of the surgical bed and another due to dehiscence of the coloproctostomy. The mean follow-up was 11 months, with 20 (87%) patients having no complications. 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引用次数: 0
摘要
目的:同时修复切口疝(IH)和重建肠道转运可能会给许多外科医生带来挑战。腹壁外科和结肠直肠外科专业单位之间的合作有利于同时进行治疗。方法:对在一个联合团队中同时接受复杂 IH 修复手术和肠道转运重建手术的患者进行描述性研究。所有手术均在腹壁和结肠直肠外科专家的合作下择期进行。结果:共纳入 23 名患者。11例结肠末端造口术,1例环状结肠造口术,6例回肠末端造口术和5例环状回肠造口术。7名(30%)患者出现内侧开腹切口疝,3名(13%)患者出现腹膜旁切口疝,13名(56%)患者出现内侧和腹膜旁切口疝。100%的病例实现了疝缺损闭合,22 例(95%)实现了肠道重建。17例患者(74%)需要进行组件分离,其中11例(48%)在后方,6例(26%)在前方。院内发病率为9%,只有两名患者的Clavien-Dindo发病率大于III级,需要再次手术,其中一名是由于手术床出血,另一名是由于结肠直肠造口开裂。平均随访时间为 11 个月,20 名(87%)患者没有出现并发症。一名患者因吻合口开裂而不得不移除网片,没有患者因手术部位感染而不得不移除网片。
Simultaneous Treatment of Complex Incisional Hernia and Stoma Reversal.
Purpose: The simultaneous repair of incisional hernias (IH) and the reconstruction of the intestinal transit may pose a challenge for many surgeons. Collaboration between units specialized in abdominal wall and colorectal surgery can favor simultaneous treatment. Methods: Descriptive study of patients undergoing simultaneous surgery of complex IH repair and intestinal transit reconstruction from the start of treatment in a joint team. All interventions were performed electively and with the collaboration of surgeons experts in abdominal wall and colorectal surgery. Results: 23 patients are included. 11 end colostomies, 1 loop colostomy, 6 end ileostomies and 5 loop ileostomies. Seven (30%) patients presented with a medial laparotomy incisional hernia, 3 (13%) with a parastomal incisional hernia, and 13 (56%) with a medial and parastomal incisional hernia. Closure of the hernial defect was achieved in 100% of cases, and reconstruction of the intestinal tract was achieved in 22 (95%). Component separation was required in 17 patients (74%), which were 11 (48%) posterior and 6 (26%) anterior. In-hospital morbidity was 9%, and only two patients presented Clavien-Dindo morbidity > III when requiring reoperation, one due to hemorrhage of the surgical bed and another due to dehiscence of the coloproctostomy. The mean follow-up was 11 months, with 20 (87%) patients having no complications. Mesh had to be removed in one patient with anastomotic dehiscence, no mesh had to be removed due to surgical site infection.