Article information
Abstract
Parastomal hernia (PH) is the most common delayed complication in stoma surgery. Only a third of these are operated on, something which is partly explained by the high recurrence rate observed after repair. The use of prosthetic materials has improved the results, although they continue to be below the ideal.
For this reason, it has been proposed that the best solution may be in preventing the PH. Several studies show promising results, with very marked reductions in the percentage of IH, on placing a prophylactic peristomal prosthesis.
In this article we present a review of the risk factors associated with PH, a classification of the existing diversity of repair techniques, and an algorithm is proposed for the management of PH, including its prevention.
Keywords:
Parastomal hernia
Prophylactic prótesis
Prevention
Preperitoneal
Resumen
La eventración paraestomal (EP) es la complicación tardía más frecuente del estoma quirúrgico. Sólo un tercio de éstas se intervienen, hecho que en parte se explica por el alto índice de recidivas observadas tras la reparación. La utilización de materiales protésicos ha mejorado los resultados, aunque siguen siendo por debajo de lo ideal.
Por esta razón, se ha propuesto que la mejor solución puede estar en prevenir la aparición de la EP. Varios trabajos muestran resultados prometedores con reducciones muy llamativas en el porcentaje de EP al colocar una prótesis periestomal profiláctica.
En este artículo presentamos una revisión de los factores de riesgo asociados a la EP y una clasificación de la diversidad de técnicas de reparación existentes, y se propone un algoritmo para el tratamiento de la EP, incluyendo la prevención de ésta.
Palabras clave:
Eventración paraestomal
Prótesis profiláctica
Prevención
Preperitoneal
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