PDF(Pubmed)
Abstract：
Parastomal hernia (PSH) is a common complication in patients receiving ileal conduit urinary diversion after radical cystectomy. In this randomized controlled clinical trial, we validate our previous finding that extraperitonealization of ileal conduit decreases incidence of PSH. In total, 104 consecutive patients undergoing radical cystectomy at Sun Yat-sen University Cancer Center are randomized 1:1 to receive either modified (extraperitonealized) ileal conduit (n = 52) or conventional ileal conduit (n = 52). Primary endpoint is incidence of radiological PSH during follow-up. Incidence of radiological PSH is lower in the modified group than in the conventional group (11.5% vs. 28.8%; p = 0.028) after a median follow-up of 32 months, corresponding to a hazard ratio of 0.374 (95% confidence interval: 0.145-0.965, p = 0.034) in the modified conduit group. The results support our previous finding that extraperitonealization of the ileal conduit is effective for reducing risk of PSH in patients receiving ileal conduit diversion.
摘要：
造口旁疝（PSH）是根治性膀胱切除术后接受回肠导管尿流改道的患者的常见并发症。在这项随机对照临床试验中，我们验证了我们之前的发现,即回肠导管腹膜外穿刺可降低PSH的发生率.总的来说,在中山大学肿瘤中心接受根治性膀胱切除术的104例连续患者随机分为1：1，分别接受改良（腹膜外）回肠导管（n=52）或常规回肠导管（n=52）。主要终点是随访期间放射性PSH的发生率。改良组放射性PSH的发生率低于常规组(11.5%vs.28.8%；p=0.028）中位随访32个月后，对应于改良导管组的风险比为0.374(95%置信区间:0.145-0.965,p=0.034).结果支持我们先前的发现，即回肠导管的腹膜外化可有效降低接受回肠导管改道的患者的PSH风险。
