{"title":"根治性膀胱切除术和回肠尿管改道后造口旁疝的处理和结果：一项系统综述。","authors":"Rui Cao, Xiangyu Shao, Junsheng Li","doi":"10.1007/s10029-025-03359-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Parastomal hernia following radical cystectomy and ileal conduit urinary diversion (ICPH) is a prevalent postoperative complication which needed a unified scheme for proper management. This review provided a comprehensive summary of the data regarding the occurrence, risk factors, surgical approaches, mesh placement, postoperative complications, and recurrence rates of ICPH, with the aim of offering valuable insights for the standardized management of ICPH.</p><p><strong>Methods: </strong>Systematic literature search was conducted up to November 2024 using databases including MEDLINE and Elsevier, supplemented by manual screening of relevant journals and reference lists. Data extraction focused on incidence, risk factors, surgical approaches, and postoperative outcomes.</p><p><strong>Results: </strong>A total of 30 studies were included, including 18 retrospective studies and 12 cases. And 3 additional systematic reviews were integrated to extract data concerning the incidence and risk factors of ICPH. The pooled ICPH incidence of 4 studies was 14.36%. Main risk factors included fascial defects ≥ 24 mm, obesity, and female sex. In the choice of surgical approach, minimally invasive techniques dominated (169/367,52%). The most frequently reported methods were the Keyhole (149/328, 45%) and Sugarbaker (113/328, 35%) techniques. In terms of mesh placement, the choice of most cases intraperitoneal placement. The most prevalent postoperative complication was urinary system complications (n = 14). Most of the complications were Clavien-Dindo grade 2 (40/68,59%). Recurrence rates varied widely (0-47%), with Keyhole-associated recurrence up to 52% versus 12.5% for Sugarbaker.</p><p><strong>Conclusion: </strong>ICPH is a clinical complication that deserves the attention of surgeons. Mesh repair is the current mainstream method. Although there are various surgical methods for mesh repair, each has its own advantages and disadvantages, and a large number of clinical studies are still needed to provide the optimal solution. In addition, the effectiveness of prophylactic mesh placement remains controversial.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"180"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management and outcomes profiles of parastomal hernia after radical cystectomy and ileal conduit urinary diversion: a systematic review.\",\"authors\":\"Rui Cao, Xiangyu Shao, Junsheng Li\",\"doi\":\"10.1007/s10029-025-03359-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Parastomal hernia following radical cystectomy and ileal conduit urinary diversion (ICPH) is a prevalent postoperative complication which needed a unified scheme for proper management. This review provided a comprehensive summary of the data regarding the occurrence, risk factors, surgical approaches, mesh placement, postoperative complications, and recurrence rates of ICPH, with the aim of offering valuable insights for the standardized management of ICPH.</p><p><strong>Methods: </strong>Systematic literature search was conducted up to November 2024 using databases including MEDLINE and Elsevier, supplemented by manual screening of relevant journals and reference lists. Data extraction focused on incidence, risk factors, surgical approaches, and postoperative outcomes.</p><p><strong>Results: </strong>A total of 30 studies were included, including 18 retrospective studies and 12 cases. And 3 additional systematic reviews were integrated to extract data concerning the incidence and risk factors of ICPH. The pooled ICPH incidence of 4 studies was 14.36%. Main risk factors included fascial defects ≥ 24 mm, obesity, and female sex. In the choice of surgical approach, minimally invasive techniques dominated (169/367,52%). The most frequently reported methods were the Keyhole (149/328, 45%) and Sugarbaker (113/328, 35%) techniques. In terms of mesh placement, the choice of most cases intraperitoneal placement. The most prevalent postoperative complication was urinary system complications (n = 14). Most of the complications were Clavien-Dindo grade 2 (40/68,59%). Recurrence rates varied widely (0-47%), with Keyhole-associated recurrence up to 52% versus 12.5% for Sugarbaker.</p><p><strong>Conclusion: </strong>ICPH is a clinical complication that deserves the attention of surgeons. Mesh repair is the current mainstream method. Although there are various surgical methods for mesh repair, each has its own advantages and disadvantages, and a large number of clinical studies are still needed to provide the optimal solution. In addition, the effectiveness of prophylactic mesh placement remains controversial.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"180\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03359-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03359-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Management and outcomes profiles of parastomal hernia after radical cystectomy and ileal conduit urinary diversion: a systematic review.
Introduction: Parastomal hernia following radical cystectomy and ileal conduit urinary diversion (ICPH) is a prevalent postoperative complication which needed a unified scheme for proper management. This review provided a comprehensive summary of the data regarding the occurrence, risk factors, surgical approaches, mesh placement, postoperative complications, and recurrence rates of ICPH, with the aim of offering valuable insights for the standardized management of ICPH.
Methods: Systematic literature search was conducted up to November 2024 using databases including MEDLINE and Elsevier, supplemented by manual screening of relevant journals and reference lists. Data extraction focused on incidence, risk factors, surgical approaches, and postoperative outcomes.
Results: A total of 30 studies were included, including 18 retrospective studies and 12 cases. And 3 additional systematic reviews were integrated to extract data concerning the incidence and risk factors of ICPH. The pooled ICPH incidence of 4 studies was 14.36%. Main risk factors included fascial defects ≥ 24 mm, obesity, and female sex. In the choice of surgical approach, minimally invasive techniques dominated (169/367,52%). The most frequently reported methods were the Keyhole (149/328, 45%) and Sugarbaker (113/328, 35%) techniques. In terms of mesh placement, the choice of most cases intraperitoneal placement. The most prevalent postoperative complication was urinary system complications (n = 14). Most of the complications were Clavien-Dindo grade 2 (40/68,59%). Recurrence rates varied widely (0-47%), with Keyhole-associated recurrence up to 52% versus 12.5% for Sugarbaker.
Conclusion: ICPH is a clinical complication that deserves the attention of surgeons. Mesh repair is the current mainstream method. Although there are various surgical methods for mesh repair, each has its own advantages and disadvantages, and a large number of clinical studies are still needed to provide the optimal solution. In addition, the effectiveness of prophylactic mesh placement remains controversial.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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