中国实用外科杂志

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造口旁疝术后复发的处理要点

李俊生   

  1. 东南大学附属中大医院普外科,江苏南京 210009
  • 出版日期:2025-05-01

  • Online:2025-05-01

摘要: 造口旁疝(PSH)的治疗是疝外科的难题之一,复发性PSH的处理更具有挑战性,处理方式与初发PSH有所不同。复发性PSH的危险因素包括高龄、肥胖、免疫抑制、腹内压增加和术后切口感染。术前需完善CT评估,考虑造口还纳或移位可能。复发性PSH的手术难度较大,并发症较多,手术方法存在不确定性,建议根据病人前次修补术方法、合并症情况和身体状态,由疝专业医师制定个体化的手术方案。

关键词: 造口旁疝, 复发性造口旁疝, 疝修补

Abstract: Parastomal hernia (PSH) is one of the challenges in hernia surgery, and the treatment of recurrent PSH is even more challenging, with different approaches from those for primary PSH. Risk factors for recurrent PSH include advanced age, obesity, immunosuppression, increased intra-abdominal pressure, and postoperative wound infection. Preoperative CT assessment should be completed, and the possibility of stoma repositioning or relocation should be considered. The surgical difficulty of recurrent PSH is greater, with more complications, and the surgical methods are uncertain. It is recommended that individualized surgical plans be developed by hernia specialists based on the patient’s previous repair method, comorbidities, and physical condition.

Key words: parastomal hernia, recurrent parastomal hernia, hernia repair