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Non-operative treatment as a strategy for patients with parastomal hernia: a multicentre, retrospective cohort study.
- Source :
-
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2018 Jun; Vol. 20 (6), pp. 545-551. - Publication Year :
- 2018
-
Abstract
- Aim: Parastomal hernia is the most common complication following stoma construction. Surgical treatment is usually chosen over non-operative treatment, but a clear rationale for the choice of management is often lacking. This study aims to investigate the reasons for non-operative treatment, cross-over rates and postoperative complications.<br />Method: A multicentre, retrospective cohort study was conducted. Patients diagnosed with a parastomal hernia between January 2007 and December 2012 were included. Data on baseline characteristics, primary surgery and hernias were collected. For non-operative treatment, reasons for this treatment and cross-over rates were evaluated. For all patients undergoing surgery (surgical treatment and cross-overs), complication and recurrence rates were analysed.<br />Results: Of the 80 patients included, 42 (53%) were in the surgical treatment group and 38 (48%) in the non-operative treatment group. Median follow-up was 46 months (interquartile range 24-72). The reasons for non-operative treatment were absence of symptoms in 12 patients (32%), comorbidities in nine (24%) and patient preference in three (7.9%). In 14 patients (37%) reasons were not documented. Eight patients (21%) crossed over from non-operative treatment to surgical treatment, of whom one needed emergency surgery. In 23 patients (55%), parastomal hernia recurred after the original surgical treatment, of whom 21 (91%) underwent additional repair.<br />Conclusion: Parastomal hernia repair is associated with high recurrence and additional repair rates. Non-operative treatment has a relatively low cross-over and emergency surgery rate. Given these data, non-operative treatment might be a better choice for patients without complaints or with comorbidities.<br /> (Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.)
- Subjects :
- Adult
Aged
Asymptomatic Diseases
Cohort Studies
Colostomy
Comorbidity
Conservative Treatment
Female
Humans
Ileostomy
Ileus epidemiology
Male
Middle Aged
Patient Preference
Postoperative Complications epidemiology
Postoperative Complications therapy
Recurrence
Retrospective Studies
Surgical Mesh
Surgical Wound Infection epidemiology
Suture Techniques
Urinary Diversion
Hernia, Abdominal therapy
Herniorrhaphy
Incisional Hernia therapy
Ostomy
Surgical Stomas
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1318
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
- Publication Type :
- Academic Journal
- Accession number :
- 29150969
- Full Text :
- https://doi.org/10.1111/codi.13962