The Experts below are selected from a list of 7986 Experts worldwide ranked by ideXlab platform
Sebastiano Biondo - One of the best experts on this subject based on the ideXlab platform.
-
prevention of parastomal hernia after abdominoperineal excision with a prophylactic three dimensional funnel mesh
Colorectal Disease, 2019Co-Authors: J Lopezborao, Esther Kreisler, Z Madrazogonzalez, Sebastiano BiondoAbstract:AIM A prophylactic three-dimensional (3D) funnel mesh using the keyhole technique (intraperitoneal onlay mesh position) in abdominoperineal excision (APR) may significantly decrease the parastomal hernia (PSH) index without increasing morbidity. The aim of this retrospective observational study was to analyse the incidence of PSH and postoperative complications in patients who underwent permanent Colostomy with the use of a prophylactic 3D preformed mesh compared with patients without a mesh. METHOD Patients who underwent an end-Colostomy after APR for primary or recurrent rectal cancer in a colorectal surgery unit were divided into two groups: group 1 without a prophylactic mesh and group 2 with a prophylactic synthetic mesh. The main end-point was to analyse the incidence of PSH after a median follow-up of 2.8 years. RESULTS One hundred and ten patients (64 in group 1 and 46 in group 2, without significant clinical differences) underwent a permanent Colostomy after APR. In group 1 70.3% developed a PSH, compared with 13% in group 2 (P < 0.001). Age (especially for patients ≥ 75 years) represented a significant risk factor for PSH. There were no differences in postoperative complications between the groups. CONCLUSION A prophylactic parastomal 3D mesh using the keyhole technique may reduce the incidence of PSH after permanent Colostomy without an increase in postoperative complications.
-
follow up of double barreled wet Colostomy after pelvic exenteration at a single institution
Diseases of The Colon & Rectum, 2010Co-Authors: Thomas Golda, Sebastiano Biondo, Esther Kreisler, Ricardo Frago, Domenico Fraccalvieri, Monica MillanAbstract:PURPOSE: Double-barreled wet Colostomy consists of simultaneous urinary and fecal diversions into a lateral Colostomy and is indicated after pelvic exenteration or in palliative operations, when complete intestinal and urinary reconstruction is not possible. We report experience at our institution with Double-barreled wet Colostomy regarding postoperative and long-term morbidity and mortality. METHODS: All patients who underwent double-barreled wet Colostomy construction at our institution from 1980 through 2008 were included in the study. Medical records were reviewed for type and history of the malignant tumor, previous treatments, comorbidity according to the American Society of Anesthesiologists' score, type and length of surgery, length of hospital stay, and postoperative (within 30 days after the operation) and long-term morbidity and mortality. RESULTS: The study comprised 41 patients. The underlying disease was a malignant pelvic tumor in 30 patients (primary in 6 and recurrent in 24 patients) and a nonmalignant disease in 11 patients. Surgical mortality was 2.4%, and the postoperative morbidity rate was 65.9%. Double-barreled wet Colostomy-related morbidity observed during follow-up included pyelonephritis (9.8%, with renal deterioration due to chronic pyelonephritis in 2.4%), stenosis of the uretero-colonic anastomosis (2.4%), and lithiasis in the urine reservoir (7.3%). Follow-up was discontinued after a mean of 18.6 (SD, 19.9) months in 14 patients who had been referred from other centers. A total of 27 patients were followed in our center for a mean of 32.2 (range, 1-156) months. Of these, 7 patients are currently alive, 1 with recurrent disease; 14 patients died from local or distant recurrence; and 6 patients died of causes other than malignancy. CONCLUSION: Double-barreled wet Colostomy is a safe alternative for patients who need simultaneous urinary and fecal diversion, although the risk of ascending urinary infection must be taken into consideration.
Monica Millan - One of the best experts on this subject based on the ideXlab platform.
-
follow up of double barreled wet Colostomy after pelvic exenteration at a single institution
Diseases of The Colon & Rectum, 2010Co-Authors: Thomas Golda, Sebastiano Biondo, Esther Kreisler, Ricardo Frago, Domenico Fraccalvieri, Monica MillanAbstract:PURPOSE: Double-barreled wet Colostomy consists of simultaneous urinary and fecal diversions into a lateral Colostomy and is indicated after pelvic exenteration or in palliative operations, when complete intestinal and urinary reconstruction is not possible. We report experience at our institution with Double-barreled wet Colostomy regarding postoperative and long-term morbidity and mortality. METHODS: All patients who underwent double-barreled wet Colostomy construction at our institution from 1980 through 2008 were included in the study. Medical records were reviewed for type and history of the malignant tumor, previous treatments, comorbidity according to the American Society of Anesthesiologists' score, type and length of surgery, length of hospital stay, and postoperative (within 30 days after the operation) and long-term morbidity and mortality. RESULTS: The study comprised 41 patients. The underlying disease was a malignant pelvic tumor in 30 patients (primary in 6 and recurrent in 24 patients) and a nonmalignant disease in 11 patients. Surgical mortality was 2.4%, and the postoperative morbidity rate was 65.9%. Double-barreled wet Colostomy-related morbidity observed during follow-up included pyelonephritis (9.8%, with renal deterioration due to chronic pyelonephritis in 2.4%), stenosis of the uretero-colonic anastomosis (2.4%), and lithiasis in the urine reservoir (7.3%). Follow-up was discontinued after a mean of 18.6 (SD, 19.9) months in 14 patients who had been referred from other centers. A total of 27 patients were followed in our center for a mean of 32.2 (range, 1-156) months. Of these, 7 patients are currently alive, 1 with recurrent disease; 14 patients died from local or distant recurrence; and 6 patients died of causes other than malignancy. CONCLUSION: Double-barreled wet Colostomy is a safe alternative for patients who need simultaneous urinary and fecal diversion, although the risk of ascending urinary infection must be taken into consideration.
Esther Kreisler - One of the best experts on this subject based on the ideXlab platform.
-
prevention of parastomal hernia after abdominoperineal excision with a prophylactic three dimensional funnel mesh
Colorectal Disease, 2019Co-Authors: J Lopezborao, Esther Kreisler, Z Madrazogonzalez, Sebastiano BiondoAbstract:AIM A prophylactic three-dimensional (3D) funnel mesh using the keyhole technique (intraperitoneal onlay mesh position) in abdominoperineal excision (APR) may significantly decrease the parastomal hernia (PSH) index without increasing morbidity. The aim of this retrospective observational study was to analyse the incidence of PSH and postoperative complications in patients who underwent permanent Colostomy with the use of a prophylactic 3D preformed mesh compared with patients without a mesh. METHOD Patients who underwent an end-Colostomy after APR for primary or recurrent rectal cancer in a colorectal surgery unit were divided into two groups: group 1 without a prophylactic mesh and group 2 with a prophylactic synthetic mesh. The main end-point was to analyse the incidence of PSH after a median follow-up of 2.8 years. RESULTS One hundred and ten patients (64 in group 1 and 46 in group 2, without significant clinical differences) underwent a permanent Colostomy after APR. In group 1 70.3% developed a PSH, compared with 13% in group 2 (P < 0.001). Age (especially for patients ≥ 75 years) represented a significant risk factor for PSH. There were no differences in postoperative complications between the groups. CONCLUSION A prophylactic parastomal 3D mesh using the keyhole technique may reduce the incidence of PSH after permanent Colostomy without an increase in postoperative complications.
-
follow up of double barreled wet Colostomy after pelvic exenteration at a single institution
Diseases of The Colon & Rectum, 2010Co-Authors: Thomas Golda, Sebastiano Biondo, Esther Kreisler, Ricardo Frago, Domenico Fraccalvieri, Monica MillanAbstract:PURPOSE: Double-barreled wet Colostomy consists of simultaneous urinary and fecal diversions into a lateral Colostomy and is indicated after pelvic exenteration or in palliative operations, when complete intestinal and urinary reconstruction is not possible. We report experience at our institution with Double-barreled wet Colostomy regarding postoperative and long-term morbidity and mortality. METHODS: All patients who underwent double-barreled wet Colostomy construction at our institution from 1980 through 2008 were included in the study. Medical records were reviewed for type and history of the malignant tumor, previous treatments, comorbidity according to the American Society of Anesthesiologists' score, type and length of surgery, length of hospital stay, and postoperative (within 30 days after the operation) and long-term morbidity and mortality. RESULTS: The study comprised 41 patients. The underlying disease was a malignant pelvic tumor in 30 patients (primary in 6 and recurrent in 24 patients) and a nonmalignant disease in 11 patients. Surgical mortality was 2.4%, and the postoperative morbidity rate was 65.9%. Double-barreled wet Colostomy-related morbidity observed during follow-up included pyelonephritis (9.8%, with renal deterioration due to chronic pyelonephritis in 2.4%), stenosis of the uretero-colonic anastomosis (2.4%), and lithiasis in the urine reservoir (7.3%). Follow-up was discontinued after a mean of 18.6 (SD, 19.9) months in 14 patients who had been referred from other centers. A total of 27 patients were followed in our center for a mean of 32.2 (range, 1-156) months. Of these, 7 patients are currently alive, 1 with recurrent disease; 14 patients died from local or distant recurrence; and 6 patients died of causes other than malignancy. CONCLUSION: Double-barreled wet Colostomy is a safe alternative for patients who need simultaneous urinary and fecal diversion, although the risk of ascending urinary infection must be taken into consideration.
Henkthijs Brandsma - One of the best experts on this subject based on the ideXlab platform.
-
prophylactic mesh placement during formation of an end Colostomy reduces the rate of parastomal hernia short term results of the dutch prevent trial
Annals of Surgery, 2017Co-Authors: Henkthijs Brandsma, Birgitta M E Hansson, T J Aufenacker, D Van Geldere, Chander Mahabier, Pascal Steenvoorde, T S De Vries Reilingh, Felix M V Lammeren, Peter Makai, Marinus J WiezerAbstract:Objective:The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-Colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional Colostomy formation.Background:A PSH is the most frequent complication after stoma formation. Sy
-
prophylactic mesh placement to prevent parastomal hernia early results of a prospective multicentre randomized trial
Hernia, 2016Co-Authors: Henkthijs Brandsma, Birgitta M E Hansson, T J Aufenacker, D Van Geldere, F M Van Lammeren, Chander Mahabier, Pascal Steenvoorde, T S De Vries Reilingh, R J Wiezer, J H W De WiltAbstract:Parastomal hernia (PSH) is a common complication after Colostomy formation. Recent studies indicate that mesh implantation during formation of a Colostomy might prevent a PSH. To determine if placement of a retromuscular mesh at the Colostomy site is a feasible, safe and effective procedure in preventing a parastomal hernia, we performed a multicentre randomized controlled trial in 11 large teaching hospitals and three university centres in The Netherlands. Augmentation of the abdominal wall with a retromuscular light-weight polypropylene mesh (Parietene Light™, Covidien) around the trephine was compared with traditional Colostomy formation. Patients undergoing elective open formation of a permanent end-Colostomy were eligible. 150 patients were randomized between 2010 and 2012. Primary endpoint of the PREVENT trial is the incidence of parastomal hernia. Secondary endpoints are morbidity, pain, quality of life, mortality and cost-effectiveness. This article focussed on the early results of the PREVENT trial and, therefore, operation time, postoperative morbidity, pain, and quality of life were measured. Outcomes represent results after 3 months of follow-up. A total of 150 patients were randomized. Mean operation time of the mesh group (N = 72) was significantly longer than in the control group (N = 78) (182.6 vs. 156.8 min; P = 0.018). Four (2.7 %) peristomal infections occurred of which one (1.4 %) in the mesh group. No infection of the mesh occurred. Most of the other infections were infections of the perineal wound, equally distributed over both groups. No statistical differences were discovered in stoma or mesh-related complications, fistula or stricture formation, pain, or quality of life. During open and elective formation of an end-Colostomy, primary placement of a retromuscular light-weight polypropylene mesh for prevention of a parastomal hernia is a safe and feasible procedure. The PREVENT trial is registered at: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2018 .
Johan F Lange - One of the best experts on this subject based on the ideXlab platform.
-
systematic review and meta analysis of extraperitoneal versus transperitoneal Colostomy for preventing parastomal hernia
Diseases of The Colon & Rectum, 2016Co-Authors: Leonard F Kroese, Gertjan Kleinrensink, J Jeekel, Gijs H J De Smet, Johan F LangeAbstract:BACKGROUND Parastomal hernia remains a frequent problem after constructing a Colostomy. Current research mainly focuses on prophylactic mesh placement as an addition to transperitoneal colostomies. However, for constructing a Colostomy, either an extraperitoneal or transperitoneal route can be chosen. OBJECTIVE The aim of this meta-analysis was to investigate which technique results in lower parastomal hernia rates in patients undergoing end Colostomy. DATA SOURCES A meta-analysis was conducted according to Preferred Items for Reporting of Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Embase, MEDLINE, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PubMed, and Google Scholar databases were searched. The study protocol was registered in the International Prospective Register of Systematic Reviews database. STUDY SELECTION Studies comparing extraperitoneal and transperitoneal colostomies were included. Only studies written in English were included. The quality of studies and risk of bias were assessed using the Cochrane risk-of-bias tool. The quality of nonrandomized studies was assessed using the Newcastle-Ottawa Scale. INTERVENTION The intervention was Colostomy formation. MAIN OUTCOME MEASURES The main outcome measure was parastomal hernia incidence. Secondary outcome measures were stoma prolapse, stoma necrosis, and operating time. RESULTS Of 401 articles found, a meta-analysis was conducted of 10 studies (2 randomized controlled trials and 8 retrospective studies) composed of 1048 patients (347 extraperitoneal and 701 transperitoneal). Extraperitoneal Colostomy led to significantly lower parastomal hernia rates (22 of 347 (6.3%) for extraperitoneal versus 125 of 701 (17.8%) for transperitoneal; risk ratio = 0.36 (95% CI, 0.21-0.62); I = 26%; p < 0.001) and significantly lower stoma prolapse rates (2 of 185 (1.1%) for extraperitoneal versus 13 of 179 (7.3%) for transperitoneal; risk ratio = 0.21 (95% CI, 0.06-0.73); I = 0%; p = 0.01). Differences in stoma necrosis were not significant. Operating time data were insufficient to analyze. LIMITATIONS Most of the studies were nonrandomized, and some were not recent publications. CONCLUSIONS Although the majority of studies included were retrospective, extraperitoneal Colostomy was observed to lead to a lower rate of parastomal hernia and stoma prolapse.
-
parastomal hernia impact on quality of life
World Journal of Surgery, 2015Co-Authors: Sven M Van Dijk, Lucas Timmermans, Eva B Deerenberg, Bas Lamme, Gertjan Kleinrensink, J Jeekel, Johan F LangeAbstract:Introduction Parastomal hernia (PH) is a frequent complication after end-Colostomy formation. PH may negatively influence the quality of life in end-Colostomy patients. Our study investigates the quality of life and body image (BI) in patients with an end-Colostomy.