腹腔镜下CK Parastomal补片修补造口旁疝疗效分析  

EFFECTIVENESS ANALYSIS OF LAPAROSCOPIC REPAIR OF PARASTOMAL HERNIA USING CK Parastomal PATCH

作　　者：刘飞德[1] 李基业[1] 王世斌[1] 姚胜[1] 朱瑛梅[1] 

机构地区：[1]解放军总医院第一附属医院普外科,北京100048

出　　处：《中国修复重建外科杂志》2011年第6期681-684,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结腹腔镜下应用CK Parastomal补片修补造口旁疝的手术方法及临床疗效。方法回顾分析2006年6月-2010年3月24例于腹腔镜下应用CK Parastomal补片修补造口旁疝患者的临床资料。男15例,女9例;年龄47～80岁,中位年龄55岁。左下腹结肠造口旁疝19例,右下腹回肠造口旁疝5例。发生造口旁疝时间1～4年,平均2.4年。疝环最大径3～7 cm,平均5.2 cm。均无疝修补史。结果 18例成功完成腹腔镜下修补,6例因腹腔内广泛致密粘连转为开放手术。手术时间78～178 min,平均121 min。术后切口均Ⅰ期愈合。术后3～7 d 8例发生浆液肿,均经穿刺抽吸后消失。术后1个月内11例出现修补区域腹壁疼痛,均自行消失。24例患者术后均获随访,随访时间6～39个月,平均27个月。术后3个月1例复发,其余患者随访期间均无复发。结论 腹腔镜下应用CK Parastomal补片修补造口旁疝是一种安全、可行的方法,可获得较好的近期疗效,但远期效果尚需进一步观察。Objective To summarize the surgical technique and the effectiveness of CK Parastomal patch in laparoscopic repair of parastomal hernia.Methods The clinical data were retrospectively analysed from 24 patients who received laparoscopic repair of parastomal hernia using CK Parastomal patch between June 2006 and March 2010.There were 15 males and 9 females with a median age of 55 years（range,47-80 years）.Among them,19 patients were with colon parastomal hernia in the left lower quadrant and 5 patients with ileum parastomal hernia in the right lower quadrant.The parastomal hernia duration was 1 to 4 years（mean,2.4 years）.The maximal diameter of the hernia ring was 3 to 7 cm（mean,5.2 cm）.All patients did not receive hernia repair.Results Laparoscopic repair of parastomal hernia was successfully performed in 18 cases,and open repair was used in 6 cases because of extensive adhesion.The average operating time was 121 minutes（range,78 to 178 minutes）.All wounds healed by first intention.Wound seroma occurred in 8 cases at 3 to 7 days after operation and disappeared by aspiration.Eleven patients complained of pain in the operative area within 1 month after operation and it disappeared without intervention.All patients were followed up 6 to 39 months（mean,27 months）.One recurrence occurred at 3 months after operation,and no recurrence occurred in the other patients.Conclusion Laparoscopic repair of parastomal hernia using CK Parastomal patch is a safe and feasible procedure with a satisfactory short-term effectiveness,but the long-term effectiveness should be further observed.

关 键 词：造口旁疝 腹腔镜 补片 疝修补 

分 类 号：R656.2[医药卫生—外科学]