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Risk factors associated to incisional hernia in stoma site after stoma closure: a systematic review and meta analysis

dc.contributor.advisorRamírez Giraldo, Camilo
dc.contributor.advisorRojas López, Susana
dc.creatorRamírez Giraldo, Camilo
dc.creatorVan Londoño, Isabella
dc.creatorHernández Ferreira, Juliana
dc.creatorHernández Álvarez, Daniela
dc.creatorRojas López, Susana
dc.creator.degreeEspecialista en Cirugía General
dc.creator.degreeLevelMaestría
dc.creator.degreetypeFull time
dc.date.accessioned2023-08-11T16:29:05Z
dc.date.available2023-08-11T16:29:05Z
dc.date.created2023-08-01
dc.descriptionEste estudio tiene como objetivo identificar qué factores de riesgo están asociados a la aparición de una hernia incisional en el sitio de un estoma después de su cierre. Esto con el fin de identificar qué pacientes se beneficiarían de una intervención preventiva y así comenzar a implementar un protocolo rentable para la colocación de mallas profilácticas en pacientes de alto riesgo. Métodos: Se realizó una revisión sistemática de PubMed, Cochrane Library y ScienceDirect de acuerdo con las guías PRISMA. Se incluyeron los estudios que informaron la incidencia, los factores de riesgo y el tiempo de seguimiento para la aparición de hernia incisional después del cierre del sitio del estoma. Se utilizaron modelos de efectos fijos y efectos aleatorios para calcular las estimaciones de las razones de probabilidad y los valores medios estandarizados con sus respectivos intervalos de confianza del 95 % agrupados. Esto para evaluar la asociación entre posibles factores de riesgo y la aparición de hernia incisional posterior al cierre del sitio del estoma. Resultados: se incluyeron 17 estudios con un total de 2899 pacientes. La proporción de incidencia entre los estudios incluidos fue del 17,78% (IC95%: 13,51 – 22,50%). De los factores evaluados obesidad (p<0,001, índice (p<0,001, d de Cohen=0,63, SE=011), presencia de hernia paraestomal (p=0,001, LogOR=1,24, SE=0,38), colostomía (p=0,001 LogOR=-0,71, SE=0,15) y estoma terminal (p=0,040, LogOR=-0,38, SE=-0,18) se asociaron con la aparición de hernia incisional en el sitio del estoma después del cierre del estoma.Conclusiones: Malla profiláctica la colocación debe considerarse como una intervención preventiva eficaz en pacientes de alto riesgo (pacientes obesos, pacientes con hernia paraestomal, colostomía y pacientes con estoma terminal) con el objetivo de reducir las tasas de hernia incisional en el sitio del estoma después del cierre sin dejar de ser rentable.
dc.description.abstractThis study aims to identify which risk factors are associated to the appearance of an incisional hernia in a stoma site after its closure. This in the sake of identifying which patients would benefit from a preventative intervention and thus start implementing a cost-effective protocol for prophylactic mesh placement in high-risk patients. Methods: A systematic review of PubMed, Cochrane library and ScienceDirect was performed according to PRISMA guidelines. Studies reporting incidence, risk factors and follow-up time for appearance of incisional hernia after stoma site closure were included. A fixed-effects and random effects models were used to calculate odds ratios’ estimates and standardized mean values with their respective grouped 95% confidence interval. This to evaluate the association between possible risk factors and the appearance of incisional hernia after stoma site closure. Results: 17 studies totaling 2899 patients were included. Incidence proportion between included studies was of 17,78% (CI95%: 13,51 – 22,50%). Out of the evaluated factors obesity (p<0,001, index (p<0,001, Cohen’s d=0.63, SE=011), presence of parastomal hernia (p=0,001, LogOR=1.24, SE=0.38), colostomy (p=0,001 LogOR=-0.71, SE=0.15) and end stoma (p=0,040, LogOR=-0,38, SE=-0,18) were associated to the appearance of incisional hernia in stoma site after stoma closure. Conclusions: Prophylactic mesh placement should be considered as an effective preventative intervention in high-risk patients (obese patients, patients with parastomal hernia, colostomy and end stoma patients) with the goal of reducing incisional hernia rates in stoma site after closure while remaining cost-effective.
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dc.identifier.doihttps://doi.org/10.48713/10336_40662
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/40662
dc.language.isospa
dc.publisherUniversidad del Rosario
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Cirugía General
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
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dc.rights.accesoAbierto (Texto Completo)
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectHernia incisional
dc.subjectCierre de estoma
dc.subjectReversión de estoma
dc.subjectFactores de riesgo
dc.subjectPrevención
dc.subject.keywordIncisional hernia
dc.subject.keywordstoma closure
dc.subject.keywordstoma reversal
dc.subject.keywordrisk factors
dc.subject.keywordprevention
dc.titleRisk factors associated to incisional hernia in stoma site after stoma closure: a systematic review and meta analysis
dc.title.TranslatedTitleFactores de riesgo asociados a la hernia incisional en el sitio del estoma posterior a su cierre: Una revisión sistemática y metaanálisis
dc.typebachelorThesis
dc.type.documentTrabajo de grado
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de grado
local.department.reportEscuela de Medicina y Ciencias de la Salud
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