腹腔镜下造口旁疝补片修补术

Laparoscopic mesh repair of parastomal hernia: Experience of 7 cases

目的探讨腹腔镜下造口旁疝补片修补术的效果。方法2004年9月-2005年12月，对7例造口旁疝进行腹腔镜补片修补术。结果6例修补成功，1例因腹腔内广泛致密粘连而中转为剖腹缝合修补。手术时间45-180min，平均109min。疝环直径4-6cm，平均5．6cm。术后暂时性腹胀2例；5例修补区域腹壁疼痛，3周内明显缓解；4例血清肿，经2-4次穿刺抽液并加压包扎后治愈。无血肿发生，未发生与手术相关的感染。术后住院时间3-8d，平均5．1d；术后随访2-15个月，平均8．3月，未见复发。结论腹腔镜造口旁疝补片修补术技术上安全、可行，早期的临床疗效较理想。

Objective To investigate the effectiveness of laparoscopic mesh repair of parastomal hernia. Methods Laparoscopic mesh repair was performed in 7 patients with parasromal hernia from September 2004 to December 2005 in this hospital. Results Laparoscopic mesh herniorrhaphy was successfully performed in 6 patients, while a conversion to open herniorrhaphy was required in 1 patient because of extensive intraperitoneal adhesion. The operating time was 45 - 180 mi （ mean, 109 min） , and the hernial diameter was 4 - 6 cm （ mean, 5.6 cm）. Transient abdominal distention happened in 2 patients. Five patients complained of a pain in operative area within 3 weeks. Seroma occurred in 4 patients and was cured by needle aspiration and pressure bandaging for 2 - 4 times. No hematoma or surgery-related infection was seen. The length of postoperative hospital stay was 3 - 8 d （ mean, 5.1 d）. Postoperative follow-up for 2 - 15 months （ mean, 8.3 months） revealed no recurrence. Conclusions Laparoscopic mesh repair of parastomal hernia is safe, effective, and feasible.