结肠造口旁疝Lap-re-Do修补术与Keyhole术的疗效对比  

Comparative study of Lap-re-Do repair and Keyhole repair for paracolostomy hernia

作　　者：黄祥 王博[2] HUANG Xiang;WANG Bo(Department of Surgery,Huangjiahu Hospital,Hubei University of Chinese Medicine,Wuhan Hubei 430010,China;Department of Hepatobiliary and Pancreatic Surgery,Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan Hubei 430010,China)

机构地区：[1]湖北中医药大学黄家湖医院外科,湖北武汉430010 [2]华中科技大学同济医学院附属协和医院肝胆胰外科,湖北武汉430010

出　　处：《局解手术学杂志》2021年第1期62-66,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较Lap-re-Do修补术与Keyhole术治疗结肠造口旁疝的疗效。方法收集80例结肠造口旁疝患者的临床资料,根据其治疗方法分为Lap-re-Do组(38例)和Keyhole组(42例)。比较2组患者手术时间、住院时间、术中出血量、疝环长径、疝囊大小、术后并发症、术后外观满意度及排便不畅情况。结果2组患者住院时间、术中出血量、疝环长径及疝囊大小比较,差异均无统计学意义(P>0.05),但手术时间组间比较,差异有统计学意义(P<0.05)。2组患者暂时性腹胀、切口感染、术后腹壁疼痛、肠损伤、肠漏、腹腔感染及造口血运障碍等并发症发生率比较,差异无统计学意义(P>0.05),而2组浆液肿发生率、复发率、术后排便不畅及造口外观满意度比较,差异有统计学意义(P<0.05)。结论Lap-re-Do修补术及Keyhole术均可用于治疗结肠造口旁疝,与Keyhole术比较,Lap-re-Do修补术可减少浆液肿及术后排便不畅的发生,降低复发率,提高外观满意度。Objective To compare the efficacy of Lap-re-Do repair and Keyhole repair for the treatment of paracolostomy hernia.Methods The clinical data of 80 patients of paracolostomy hernia were collected,and they were divided into the Lap-re-Do group(38 cases)and the Keyhole group(42 cases)according to the therapeutic method.The operation time,hospitalization time,intraoperative bleeding volume,length of hernia ring,size of hernia sac,postoperative complications,postoperative appearance satisfaction and dysdefecation were compared between the two groups.Results There was no significant difference in hospitalization time,intraoperative bleeding volume,length of hernia ring and size of hernia sac between the two groups(P>0.05),but there was significant difference in the operation time between the two groups(P<0.05).There was no significant difference between the two groups in the incidence of temporary abdominal distention,incision infection,postoperative abdominal wall pain,intestinal injury,intestinal leakage,intraperitoneal infection and blood circulation disorder of stoma(P>0.05),but there were significant differences in serous swelling,recurrence,poor defecation and satisfaction with the appearance of stoma between the two groups(P<0.05).Conclusion Both Lap-re-Do repair and Keyhole repair are available for the treatment of paracolostomy hernia.Compared with the Keyhole repair,Lap-re-Do repair has the advantages of reducing the rate of recurrence,serous swelling,poor defecation,and improving the appearance satisfaction.

关 键 词：结肠造口旁疝 疝修补术 Lap-re-Do技术 Keyhole技术 

分 类 号：R656.99[医药卫生—外科学]