膀胱切除术后造口旁疝的治疗  

Treatment of parastomal hernia after cystectomy for bladder

作　　者：许熠 邵翔宇[2] 李俊生[2] Xu Yi;Shao Xiangyu;Li Junsheng(Department of Medical,Southeast University,Nanjing 210009,China;Department of General Surgery,Affiliated Zhongda Hospital,Southeast University,Nanjing,210009,China)

机构地区：[1]东南大学医学院,南京210009 [2]东南大学附属中大医院普外科,南京210009

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第3期262-265,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探究膀胱切除术后造口旁疝手术修复方式及其有效性。方法2020—2024年东南大学附属中大医院共对4例膀胱切除术后造口旁疝进行手术修补,其中回肠代膀胱造口旁疝3例,输尿管造口旁疝1例。结果4例患者造口旁腹壁缺损大小不一,根据患者具体情况选择合适术式,手术顺利。Sugarbaker法修补2例,均使用腹腔镜修补;Keyhole法修补2例,其中开放手术1例,使用腹腔镜1例。术后均未见血肿、血清肿、手术相关感染等术后并发症;术后随访2年,随访期间均未出现复发、补片感染、慢性疼痛。结论膀胱切除术后造口旁疝的修复方式、补片置入层次需根据患者具体情况进行选择或联合应用,不同术式均具有安全有效性,临床结果理想。Objective To investigate the surgical repair method of parastomal hernia after cystectomy for bladder and its effectiveness.Methods From 2020 to 2024,a total of 4 cases of parastomal hernia after bladder cystectomy were surgically repaired in Affiliated Zhongda Hospital,Southeast University,including 3 cases of ileostomy hernia and 1 case of ureterostomy hernia.Results The size of the parastomal abdominal wall defects varied among the 4 patients,and appropriate surgical procedures were selected according to the specific conditions of the patients,and the operation went smoothly:2 cases were repaired by Sugarbaker's method,both of which were repaired by laparoscopy;2 cases were repaired by keyhole method,of which 1 was open and 1 was repaired by laparoscopy.There were no postoperative complications such as hematoma,seroma,or surgery-related infections in any of the cases.The patients were followed up for 2 years after surgery,and no recurrence,mesh infection,or chronic pain occurred during the follow-up period.Conclusion The method of repair of parastomal hernia after cystectomy and the level of mesh placement should be selected or combined according to the patient's specific situation,and the different surgical procedures are safe and effective,with ideal clinical outcomes.

关 键 词：膀胱切除 尿路转流 回肠代膀胱 造口旁疝 

分 类 号：R656.2[医药卫生—外科学]