Reinforced tissue matrix to strengthen the abdominal wall following reversal of temporary ostomies or to treat incisional hernias  

作　　者：Spencer P Lake Corey R Deeken Amit K Agarwal 

机构地区：[1]Mechanical Engineering&Materials Science,Washington University in St.Louis,St.Louis,MO 63130,United States [2]Covalent Bio,LLC,St.Louis,MO 63025,United States [3]Department of Surgery,McGovern Medical School at UTHealth,Houston,TX 77026,United States

出　　处：《World Journal of Gastrointestinal Surgery》2024年第3期823-832,共10页世界胃肠外科杂志（英文版）（电子版）

基　　金：This study was reviewed and approved by the UT Health Houston Institutional Review Board(approval No.HSC-MS-23-0471).

摘　　要：BACKGROUND Abdominal wall deficiencies or weakness are a common complication of tem-porary ostomies,and incisional hernias frequently develop after colostomy or ileostomy takedown.The use of synthetic meshes to reinforce the abdominal wall has reduced hernia occurrence.Biologic meshes have also been used to enhance healing,particularly in contaminated conditions.Reinforced tissue matrices(R-TMs),which include a biologic scaffold of native extracellular matrix and a syn-thetic component for added strength/durability,are designed to take advantage of aspects of both synthetic and biologic materials.To date,RTMs have not been reported to reinforce the abdominal wall following stoma reversal.METHODS Twenty-eight patients were selected with a parastomal and/or incisional hernia who had received a temporary ileostomy or colostomy for fecal diversion after rectal cancer treatment or trauma.Following hernia repair and proximal stoma closure,RTM(OviTex®1S permanent or OviTex®LPR)was placed to reinforce the abdominal wall using a laparoscopic,robotic,or open surgical approach.Post-operative follow-up was performed at 1 month and 1 year.Hernia recurrence was determined by physical examination and,when necessary,via computed tomo-graphy scan.Secondary endpoints included length of hospital stay,time to return to work,and hospital readmissions.Evaluated complications of the wound/repair site included presence of surgical site infection,seroma,hematoma,wound dehiscence,or fistula formation.RESULTS The observational study cohort included 16 male and 12 female patients with average age of 58.5 years±16.3 years and average body mass index of 26.2 kg/m^(2)±4.1 kg/m^(2).Patients presented with a parastomal hernia(75.0%),in-cisional hernia(14.3%),or combined parastomal/incisional hernia(10.7%).Using a laparoscopic(53.6%),robotic(35.7%),or open(10.7%)technique,RTMs(OviTex®LPR:82.1%,OviTex®1S:17.9%)were placed using sublay(82.1%)or intraperitoneal onlay(IPOM;17.9%)mesh positioning.At 1-month and 1-year follow-ups,there were no he

关 键 词：Reinforced tissue matrix Reinforced forestomach matrix ILEOSTOMY COLOSTOMY Ostomy takedown Incisional hernia Abdominal wall 

分 类 号：R655.4[医药卫生—外科学]