Abstract:

Clinical research of two kinds of open operation in herniorrhaphy with artificial synthetic material for parastomal hernias SHEN Ying-mo, CHEN Jie. Center of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China Abstract Objective To evaluate the effect of two kinds of open operation in herniorrhaphy with artificial synthetic material for parastomal hernias by the application with the method of IPOM or Onlay respectively. Methods The clinical data of 48 patients with parastomal hernia admitted from January 2002 to July 2007 at Beijing Chaoyang Hospital of Capital University of Medical Science were analyzed retrospectively. Twenty-five patients received Bard CK parastomal patch repair (IPOM group). Twenty-three patients received Bard Marlex mesh repair (Onlay group). Data collected included operation time, days of postoperative stay, the cases of postoperative complications. The data were analyzed by statistical method. Results No significant difference was found between the two groups in the operation time and the days of postoperative stay. During the follow up period of 6～72 months, there was no recurrence but there were 2 cases of wound infection, 2 cases of subcutaneous seroma and 3 cases of postoperative chronic pain or foreign body sensation in the IPOM group. There were 5 cases of recurrence, 4 cases of wound infection, 6 cases of subcutaneous seroma and 9 cases of postoperative chronic pain or foreign body sensation in the Onlay group. The incidence of recurrence and postoperative chronic pain or foreign body sensation in the IPOM group were lower than those in the Onlay group significantly (P<0.05). Conclusion The two kinds of open operation in herniorrhaphy with artificial synthetic material for parastomal hernias are safe and effective surgical procedures. The method of IPOM can diminish the incidence of recurrence and postoperative chronic pain or foreign body sensation, and diminish the incidence of postoperative wound infection and subcutaneous seroma.

Key words: parastomal hernia, herniorrhaphy, artificial synthetic material

摘要：

目的　评价比较内置法和外置法人工合成材料修补法治疗造口旁疝的效果。 方法　回顾性分析2002年1月至2007年7月首都医科大学附属北京朝阳医院收治的48例造口旁疝病人的临床资料。25例行内置法修补，23例行外置法修补。对两组病人的手术时间、术后住院天数及术后各种并发症的发生情况进行统计学分析。 结果　内置法组手术时间（130.00±28.28）min，术后住院（14.16±5.41）d；外置法组手术时间（143.91±28.88）min，术后住院（17.48±6.37）d。随访6～72个月，内置法组术后没有复发，有2例伤口感染，2例皮下积液，3例出现局部慢性疼痛或异物感；外置法组有5例复发，4例伤口感染，6例皮下积液，9例出现慢性疼痛或异物感。复发与术后慢性疼痛或异物感的发生率，内置法组明显低于外置法组（P<0.05）。 结论　两种人工合成材料修补法在开放式造口旁疝修补术中的应用安全有效，内置法可减少术后复发与局部慢性疼痛或异物感的发生，还可减少术后伤口感染与皮下积液发生的可能。

关键词: 造口旁疝, 疝修补术, 人工合成材料