中国实用外科杂志

中国实用外科杂志

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经同侧腹直肌易位造口腹腔镜造口旁疝修补术17例疗效分析

李伟东，王    东，纪艳超，张    霞，张    岩，刘    昶   

  1. 哈尔滨医科大学附属第四医院普外三科，黑龙江哈尔滨 150001
  • 出版日期:2017-11-01 发布日期:2017-11-01

  • Online:2017-11-01 Published:2017-11-01

摘要：

目的    评价应用经同侧腹直肌易位造口的腹腔镜造口旁疝修补术疗效。方法    回顾性分析2015年1月至2016年12月期间在哈尔滨医科大学附属第四医院行腹腔镜下修补并经腹直肌易位造口治疗的17例造口旁疝病人的临床资料。结果    17例病人均顺利完成经同侧腹直肌易位造口，在腹腔镜下放置补片加强造口周围腹壁及修补原部位腹壁缺损，其中应用Keyhole修补法6例，Sugarbaker法11例。手术时间为139.1（90~200）min，术后住院时间为13.9（10~18）d。术后发生切口感染2例，疼痛3例（4~5周后缓解）。术后随访10.5（4~19）个月，所有病人均恢复腹壁形态及功能和造口功能，新造口未发生造口相关并发症。结论    经同侧腹直肌易位造口腹腔镜造口旁疝修补术治疗造口不满意的造口旁疝治疗效果明显，并发症发生率及复发率低，安全可行。

关键词: 造口旁疝, 易位造口, 腹腔镜, 疝修补术

Abstract:

Curative effect of laparoscopic parastomal hernia repair with stoma relocation trans ispilateral rectus abdominis: An analysis of 17 cases        LI Wei-dong, WANG Dong, JI Yan-chao, et al. Department of General Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Corresponding author: LIU Chang, E-mail:liuc72@hotmail.com
Abstract    Objective    To evaluate the effectiveness and safety of laparoscopic parastomal hernia repair with stoma relocation trans ipsilateral rectus abdominis. Methods    The clinical data of 17 cases of parastomal hernia performed laparoscopic parsatomal hernia repair and stoma relocation trans ispilateral rectus abdominis from January 2015 to December 2016 in the Fourth Affiliated Hospital of Harbin Medical University were analyzed retrospectively. Results All the 17 cases were treated successfully by stoma relocation trans ispilateral rectus abdominis and mesh were placed to strengthen the both new stoma area and original part of the abdominal wall defects. Six cases were performed by Keyhole procedure and 11 by Sugarbaker procedure. Mean operation time was 139.1 ( 90-200) min and postoperative hospital stay was 13.9 (10-18) day. Two cases had incisional infection and 3 cases had abdominal pain that could be alleviated in 4 to 5 weeks. All the cases were followed up for 10.5（4 to 19）months. All the cases were restored not only abdominal wall morphology and function, but also stoma function. There were no stoma related complication in the new stoma. Conclusion    It is effective, safe and feasible to repair parastomal hernia with unsatisfied stoma and complex hernia by laparoscopic parsatomal hernia repair and stoma relocation trans ispilateral rectus abdominis,with lower complications and the recurrence rate.

Key words: parastomal hernia, stoma relocation, laparoscope, hernia repair