PDF(Pubmed)
Abstract：
The treatment of parastomal hernias (PSH) represents a major challenge in hernia surgery. Various techniques have been reported with different outcomes in terms of complication and recurrence rates. The aim of this study is to share our initial experience with the implantation of the DynaMesh-IPST-R and -IPST, intraperitoneal funnel meshes made of polyvinylidene fluoride (PVDF). This is a retrospective observational cohort study of patients treated for PSH between March 2019 and April 2023 using the chimney technique with the intraperitoneal funnel meshes IPST-R or IPST. The primary outcome was recurrence and the secondary outcomes were intraoperative and postoperative complications, the latter assessed using the Clavien-Dindo classification. A total of 21 consecutive patients were treated with intraperitoneal PVDF funnel meshes, 17 with IPST-R and 4 with IPST. There were no intraoperative complications. Overall, no complications occurred in 61.9% (n = 12) of the patients. Major postoperative complications (defined as Clavien-Dindo ≥ 3b) were noted in four cases (19.0%). During the mean follow-up period of 21.6 (range 4.8-37.5) months, one patient (4.8%) had a recurrence. In conclusion, for the treatment of parastomal hernias, the implantation of IPST-R or IPST mesh has proven to be efficient, easy to handle, and very safe. In particular, the low recurrence rate of 4.8%, which is in line with the current literature, is convincing. However, a larger number of patients would improve the validity of the results.
摘要：
造口旁疝（PSH）的治疗是疝手术的主要挑战。据报道，各种技术在并发症和复发率方面具有不同的结果。这项研究的目的是分享我们植入DynaMesh-IPST-R和-IPST的初步经验，由聚偏氟乙烯（PVDF）制成的腹膜内漏斗网。这是一项回顾性观察性队列研究，对2019年3月至2023年4月期间使用烟囱技术与腹膜内漏斗网眼IPST-R或IPST进行PSH治疗的患者进行了研究。主要结果是复发，次要结果是术中和术后并发症，后者使用Clavien-Dindo分类进行评估。共21例连续患者接受腹膜内PVDF漏斗网片治疗，17与IPST-R和4与IPST。术中无并发症。总的来说,61.9%(n=12)的患者无并发症发生.4例（19.0%）出现严重的术后并发症（定义为Clavien-Dindo≥3b）。在平均21.6（范围4.8-37.5）个月的随访期间，1例(4.8%)复发.总之,用于治疗造口旁疝，IPST-R或IPST网状物的植入已被证明是有效的，易于处理,而且非常安全.特别是,低复发率4.8%,这与当前的文献一致，是令人信服的。然而,更多的患者将提高结果的有效性.
