Diagnostic methods in parastomal hernia; research and clinical relevance

Excerpt

The European Hernia Society’s classification of parastomal hernia (PSH) [1] is based on size and concurrence of incisional hernia (IH) as perceived intraoperatively—and thus related to difficulty in repair. Other classifications are based on clinical (bulge or no bulge) or imaging diagnostic methods as the Moreno-Mathias (M-M) [2] CT classification, which is often used in studies on PSH. Type Ia and Ib are defined as a hernia with the bowel forming the stoma prolapsing and with a perceived peritoneal sac of less or more than 5 cm. The type Ia PSH is by the inceptors described as a “pre-hernial” condition. Type II is omental fat through the ostomy alongside the bowel forming the stoma, and type III is a herniating bowel loop other than the stoma-forming bowel. Scientific reports do not classify or use classifications uniformly, which creates a problem with comparison of results. This problem is addressed in a recent meta-analysis, which advises prerequisites for future PSH research [3]. Based on observations in a randomized clinical trial (RCT), the aim of this report is to discuss the usability and clinical relevance of diagnostic methods used in scientific reports. …