Parastomalis sérvek megelőzése és megoldása: a háromdimenziós hálókkal szerzett eddigi tapasztalataink

Abstract

Our results correlate with other studies where mesh insertion was used to prevent and/or repair parastomal hernias. We attribute these results mainly to the special, 3-dimensional design of the meshes used by us. This construction was developed based on understanding the patomechanism of parastomal hernia formation.

Parastomal Hernia Prevention With Mesh in the Context of Laparoscopic Approach: An Opinion Based on Current Literature

“…Similarly to the aforementioned ObS, the RCTs found comprise a limited number of patients (212 patients) and only three studies exclusively analyze patients operated on by laparoscopic approach ( 4 , 21, 23 ). Regarding mesh position, no uniformity was followed because two used an IPOM keyhole position ( 4 , 21 ), one a retromuscular keyhole ( 20 ), one a 3D implant around stoma ( 22 ), and one an IPOM modified Sugarbaker technique ( 23 ). Also, in all RCTs ( 4, 20 – 23 ) the follow-up was 2 years or less, and the type of mesh was heterogeneous, including biological ( 20 ) and synthetic non-absorbable meshes ( 4, 21 – 23 ).…”

“…Furthermore, the mesh used in one RCT ( 23 ) has been withdrawn from the market ( 30 ). Regarding conclusions, two studies state that PH prevention using a laparoscopic approach is safe and effective ( 4 , 23 ), in one study the mesh was clinically effective but radiologically ineffective ( 21 ), in one the conclusion was that the mesh did not significantly reduce the incidence of PH ( 20 ), and finally, one of the RCTs was an interim analysis, and no statistical analysis was performed ( 22 ).…”