不同手术方式治疗腹壁造口旁疝24例  

Different operative ways of 24 patients with parastomal hernia

作　　者：洪磊[1] 项和平[1] 杨文奇[2] 

机构地区：[1]安徽医科大学第二附属医院急诊外科,合肥230601 [2]安徽医科大学第一附属医院普外科

出　　处：《中华疝和腹壁外科杂志（电子版）》2013年第6期48-50,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨造口旁疝的病因、修补方法及临床疗效。方法回顾性分析2006年7月至2010年7月安徽医科大学第二附属医院收治的腹壁造口旁疝64例,手术治疗24例,比较三种手术方式的术后复发率及并发症情况。结果行Onlay修补术5例,复发1例,复发率20%。行Sublay修补术12例,复发2例,复发率16.66%;出现皮下积液、切口感染3例。行IPOM修补术7例,复发1例,复发率14.28%;出现肠粘连肠梗阻症状1例,出现肠漏1例。三组手术方式相比,IPOM及Sublay修补术造口复发率稍低,但无统计学意义(χ2=0.462,P=1.000)。预防性使用补片病例无一例发生造口旁疝,造口旁疝发生率低于常规手术组(χ2=1.533,P=0.539)。结论造口旁疝发病率较高,修补术后复发率高,并发症多,至今仍无统一的修补标准。预防性放置补片可有效的降低造口旁疝发生率。Objective A total of 64 patients with parastomal hernia were retrospectively analyzed. The procedure and the effectiveness of parastomal hernia repair were investigated. Methods All the patients with parstomal hernia were selected. Of all, 24 patients were repaired by operation. The recurrence and complication of the three operation methods were compared. Results Five patients were applied with onlay technique for repair, one （20%） ease recurred. Twelve patients were applied with Sublay technique for repair,2（ 16.66% ） cases recurred and 3 cases suffered with subcutaneous effusion or infection of incision. Seven patients used IPOM technique for repair, and one （14.28%） case recurred. One case suffered with intestinal obstruction, and another case suffered with intestinal leakage. The recurrence rate of repair technique of IPOM and Sublay is low without any statistical sigaificaxtce（x2 = 0.462 ,P = 1. 000）. There is no case suffered with parastomal hernias in the cases of the technique which places a prophylactic mesh at the primary operation （X2 = 1. 533, P = 0. 539 ）. Conclusions The incidence of parastomal hernia and recurrence rate after repair operation are high. There is no uniform criterion for repair operation. The technique of prophylactic mesh at the primary operation may reduce the incidence of parastomal hernia.

关 键 词：疝 疝修补术 手术后并发症 

分 类 号：R656.2[医药卫生—外科学]