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3 results on '"Ostomy/adverse effects"'

1. 手助腹腔镜腹膜外造瘘联合盆底腹膜重建的研究.

Author

熊亚立, 康清杰, 向瑶, 覃川, and 向征

Abstract

Objective To explore the application value of extraperitoneal colostomy combined with pelvic peritoneal reconstruction in the hand-assisted laparoscopic radical resection of rectal carcinoma. Methods Totally 65 cases of rectal cancer undergoing hand-assisted laparoscopic transabdominal-perineal radical resection of rectal carcinoma within a definite time were selected and divided into the observation group (35 cases) and control group (30 cases) according to the odd and even number of admission. The observation group was performed the extraperitoneal tunnel-type colostomy combined with pelvic floor peritoneal closure, while the control group was performed the intraperitoneal colostomy without pelvic peritoneal closure. The differences in postoperative complications and defecation function were analyzed and compared between the two groups. Results The total occurrence rate of complications such as parastomal hernia and long term stoma in the observation group was significantly lower than that in the control group, the cases number of having defecation feeling and stool forming in the observation group was more than that in the control group, while the cases number of defecation frequency obvious increase was less than that in the control group, and the differences were statistically significant (P<0.05). Conclusion Hand-assisted laparoscopic extraperitoneal colostomy combined with pelvic peritoneal reconstruction may reduce the stomal complications and improve the life quality of patients. [ABSTRACT FROM AUTHOR]

Published
2016
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2. Closed-wound negative pressure therapy dressing after loop ostomy closure: a retrospective comparative study

Author

Curchod, P., Clerc, D., Jurt, J., Hubner, M., Hahnloser, D., Demartines, N., and Grass, F.

Subjects
Multidisciplinary, Bandages/adverse effects, Humans, Negative-Pressure Wound Therapy, Ostomy/adverse effects, Retrospective Studies, Surgical Wound Infection/etiology, Surgical Wound Infection/prevention & control, Ostomy, Surgical Wound Infection, Bandages
Abstract

Closed-wound negative pressure wound therapy (NPWT) dressings were recently introduced with the purpose to reduce incisional surgical site infections (iSSI) in high-risk wounds. The aim of this study was to compare iSSI rates in patients after ostomy closure with and without additional application of a closed-wound NPWT dressing. Single-center retrospective analysis of consecutive patients undergoing ileo- or colostomy closure over an 8-year period (January 2013—January 2021). Intradermal non-purse string technique with absorbable sutures were used in all patients. Since November 2018, all patients (study group) received a NPWT device for a maximum of 5 days postoperatively (PICO, SMITH AND NEPHEW). Primary outcome was iSSI rate within 30 days of surgery. SSI was defined in accordance with the Center of Disease Control (CDC) classification and included superficial and deep incisional SSI. Data was retrieved from the institutional enhanced recovery after surgery (ERAS) database, with standardized complication assessment by trained abstractors. In total, 85 patients (25%) in the study group were comparable with 252 (75%) patients in the control group regarding demographics (age, gender, body mass index, ASA score), ostomy type and anastomotic technique (all p > 0.05), but not wound contamination class (class III: 5% vs 0%, p p = 0.097). These preliminary results suggest a potential benefit of systematic application of the NPWT device after loop ostomy closure. A randomized controlled study is needed.

Published
2021

3. European Hernia Society guidelines on prevention and treatment of parastomal hernias

Author

Antoniou, S A, Agresta, F, Garcia Alamino, J M, Berger, D, Berrevoet, F, Brandsma, H-T, Bury, K, Conze, J, Cuccurullo, D, Dietz, U A, Fortelny, R H, Frei-Lanter, C, Hansson, B, Helgstrand, F, Hotouras, A, Jänes, A, Kroese, L F, Lambrecht, J R, Kyle-Leinhase, I, López-Cano, M, Maggiori, L, Mandalà, V, Miserez, M, Montgomery, A, Morales-Conde, S, Prudhomme, M, Rautio, T, Smart, N, Śmietański, M, Szczepkowski, M, Stabilini, C, Muysoms, F E, Antoniou, S A, Agresta, F, Garcia Alamino, J M, Berger, D, Berrevoet, F, Brandsma, H-T, Bury, K, Conze, J, Cuccurullo, D, Dietz, U A, Fortelny, R H, Frei-Lanter, C, Hansson, B, Helgstrand, F, Hotouras, A, Jänes, A, Kroese, L F, Lambrecht, J R, Kyle-Leinhase, I, López-Cano, M, Maggiori, L, Mandalà, V, Miserez, M, Montgomery, A, Morales-Conde, S, Prudhomme, M, Rautio, T, Smart, N, Śmietański, M, Szczepkowski, M, Stabilini, C, and Muysoms, F E

Abstract

BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project.METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched. Quality assessment was performed using Scottish Intercollegiate Guidelines Network checklists. The guidelines were presented at the 38th European Hernia Society Congress and each key question was evaluated in a consensus voting of congress participants.RESULTS: End colostomy is associated with a higher incidence of parastomal hernia, compared to other types of stomas. Clinical examination is necessary for the diagnosis of parastomal hernia, whereas computed tomography scan or ultrasonography may be performed in cases of diagnostic uncertainty. Currently available classifications are not validated; however, we suggest the use of the European Hernia Society classification for uniform research reporting. There is insufficient evidence on the policy of watchful waiting, the route and location of stoma construction, and the size of the aperture. The use of a prophylactic synthetic non-absorbable mesh upon construction of an end colostomy is strongly recommended. No such recommendation can be made for other types of stomas at present. It is strongly recommended to avoid performing a suture repair for elective parastomal hernia. So far, there is no sufficient comparative evidence on specific techniques, open or laparoscopic surgery and specific mesh types. However, a mesh without a hole is suggested in preference to a keyhole mesh when laparoscopic repair is performed.CONCLUSION: An evidence-based approach to the diagn

Published
2018

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