结直肠癌相关预防性末端回肠造口部位切口疝研究进展  

Research progress of stoma-site incisional hernia associatedwithcolorectal cancer

作　　者：徐嫄蕙 陈倬仪 张子臻[1] 曹晖[1] CHOI Un Wai;CHAN Cheokl;ZHANG Zi-zhen(Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,上海200127

出　　处：《中国实用外科杂志》2023年第5期587-590,596,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(No.82173215)。

摘　　要：预防性末端回肠造口是一种常用的结直肠外科手段,有助于降低吻合口漏的发生率。但相应的造口还纳术后造口部位切口疝(SSIH)是其不可忽视的远期并发症。SSIH不仅增加二次手术的创伤及额外的医疗负担,亦会降低病人生活质量。SSIH的发生率0~38.5%,影像学检查可提高检出率。除普通切口疝相关危险因素外,结直肠癌相关SSIH的特殊危险因素还包括肿瘤病程、化疗、合并中线切口疝及造口旁疝、造口还纳时间、手术缝合方法等,值得引起特别关注。SSIH危险因素多、发病率高,并且二次修补手术是唯一治愈方法。因此,有效的预防措施至关重要。造口还纳术同期预防性置入材料补片是目前SSIH相关临床研究热点。结直肠癌相关SSIH值得胃肠外科和疝外科医生关注,了解其发病机制、危险因素、治疗和预防方法,降低其发生率具有重要的临床和卫生经济学意义。Prophylactic enterostomy is a commonly used colorectal surgical procedure that helps to reduce the incidence of anastomotic leaks.However,stoma-site incisional hernia(SSIH)is a long-term complication that cannot be overlooked after stoma closure,which not only increases the trauma and additional medical burden of a second operation but also decreases the quality of life of patients.The incidence of SSIH is 0-38.5%,and radiological imaging increases the detection rate even more.In addition to risk factors similar to a common incisional hernia,risk factors for SSIH associated with colorectal cancer,such as tumorrelated factors,chemotherapy,combined midline incisional hernia and parastomal hernia,stoma closure time,surgical methods,and suturing techniques,deserve more attention.Surgery is the only effective treatment for SSIH,thus highlighting the importance of prevention.Prophylactic placement of meshes concurrently with stoma closure is a hot spot in clinical research on SSIH.Given the high incidence of SSIH,SSIH deserves the attention of gastrointestinal and hernia surgeons,and it is crucial to understand its occurrence,risk factors,treatment,and prevention methods in order to provide a theoretical basis for the development of preventive interventions for SSIH.

关 键 词：造口部位切口疝 结直肠癌 预防性末端回肠造口 

分 类 号：R6[医药卫生—外科学]