Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study

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Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh : A Randomised Study

Liedberg, Fredrik (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urology - urothelial cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Kollberg, Petter (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urology - urothelial cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Helsingborg Hospital,Skåne University Hospital

Allerbo, Marie (författare): Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden

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Baseckas, Gediminas (författare): Institution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden

Brändstedt, Johan (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Gudjonsson, Sigurdur (författare): Department of Urology, Landspitali University Hospital, Reykjavik, Iceland,National University Hospital of Iceland

Hagberg, Oskar (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Region Skåne

Håkansson, Ulf (författare): Department of Urology, Skåne University Hospital, Malmö, Sweden

Jerlström, Tomas, 1969- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Urology

Löfgren, Annica (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups

Patschan, Oliver (författare): Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Urological cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Sörenby, Anne (författare): Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital

Bläckberg, Mats (författare): Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden

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(creator_code:org_t)

Elsevier, 2020
2020
Engelska.
Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 78:5, s. 757-763

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://doi.org/10.1...; http://dx.doi.org/10...; https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

BACKGROUND: Parastomal hernia (PSH) after urinary diversion with ileal conduit is frequently a clinical problem.OBJECTIVE: To investigate whether a prophylactic lightweight mesh in the sublay position can reduce the cumulative incidence of PSH after open cystectomy with ileal conduit.DESIGN, SETTING, AND PARTICIPANTS: From 2012 to 2017, we randomised 242 patients 1:1 to conventional stoma construction (n = 124) or prophylactic mesh (n = 118) at three Swedish hospitals (ISRCTN 95093825).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint was clinical PSH, and secondary endpoints were radiological PSH assessed in prone position with the stoma in the centre of a ring, parastomal bulging, and complications from the mesh.RESULTS AND LIMITATIONS: Within 24 mo, 20/89 (23%) patients in the control arm and 10/92 (11%) in the intervention arm had developed a clinical PSH (p = 0.06) after a median follow-up of 3 yr, corresponding to a hazard ratio of 0.45 (confidence interval 0.24-0.86, p = 0.02) in the intervention arm. The proportions of radiological PSHs within 24 mo were 22/89 (25%) and 17/92 (19%) in the two study arms. During follow-up, five patients in the control arm and two in the intervention arm were operated for PSH. The median operating time was 50 min longer in patients receiving a mesh. No differences were noted in proportions of Clavien-Dindo complications at 90 d postoperatively or in complications related to the mesh during follow-up.CONCLUSIONS: Prophylactic implantation of a lightweight mesh in the sublay position decreases the risk of PSH when constructing an ileal conduit without increasing the risk of complications related to the mesh. The median surgical time is prolonged by mesh implantation.PATIENT SUMMARY: In this randomised report, we looked at the risk of parastomal hernia after cystectomy and urinary diversion with ileal conduit with or without the use of a prophylactic mesh. We conclude that such a prophylactic measure decreased the occurrence of parastomal hernias, with only a slight increase in operating time and no added risk of complications related to the mesh.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Bladder cancer
Cystectomy
Ileal conduit
Parastomal hernia
Prophylactic mesh
Bladder cancer
Cystectomy
Ileal conduit
Parastomal hernia
Prophylactic mesh

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Av författaren/redakt...: Liedberg, Fredri ...; Kollberg, Petter; Allerbo, Marie; Baseckas, Gedimi ...; Brändstedt, Joha ...; Gudjonsson, Sigu ...; visa fler...; Hagberg, Oskar; Håkansson, Ulf; Jerlström, Tomas ...; Löfgren, Annica; Patschan, Oliver; Sörenby, Anne; Bläckberg, Mats; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Urologi och njur ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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Av lärosätet: Örebro universitet; Lunds universitet

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