Outcomes using a bioprosthetic mesh at the time of permanent stoma creation in preventing a parastomal hernia: a value analysis

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• 作者：Nicole A. Figel ; M.D.^a ; Jack W. Rostas ; M.D.^b ; C. Neal Ellis ; M.D.^a ; ^c ; ^{clyde.ellis@va.gov}
• 关键词：Parastomal hernia ; Prevention ; Biological mesh
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：March, 2012
• 卷：203
• 期：3
• 页码：323-326
• 文件大小：147 K

摘要

Purpose/methods

A retrospective review of the medical records of all patients who had a prosthetic placed at the time of stoma creation for the prevention of a parastomal hernia was performed. The purpose of this study was to evaluate the safety, efficacy, and cost-effectiveness of bioprosthetics.

Results

A bioprosthetic was used in 16 patients to prevent the occurrence of a parastomal hernia. The median follow-up was 38 months. There were no mesh-related complications, and no parastomal hernias occurred. On value analysis, to be cost-effective, the percentage of patients who would have subsequently needed surgical repair of a parastomal hernia would have to be in excess of 39%or the bioprosthetic would have to cost less than $2,267 to $4,312.

Conclusions

These data show the safety and efficacy of using a bioprosthetic at the time of permanent stoma creation in preventing a parastomal hernia and defines the parameters for this approach to be cost-effective.