人工材料在嵌顿及绞窄性造口旁疝修补术的应用

The application of artificial synthetic materials in the repair of parastomal hernias with incarceration or strangulation

目的探讨嵌顿、绞窄性造口旁疝开放式人工材料修补术的合理性与评价。方法回顾性分析我院2006年3月至2007年9月采用一期人工材料修补治疗嵌顿、绞窄性造口旁疝6例的临床资料。结果全组患者无死亡及腹腔感染。腹膜前用聚丙稀补片修补1例,发生切口感染,20d后取出补片,行原位腹腔内无张力造口旁疝修补术治愈。1例发生切口脂肪液化,经短时间换药治愈。无其他术后并发症。手术时间120～160min,平均130min;住院时间12～35d,平均17d;术后随访时间3～21个月,平均为11个月,未见早期复发。结论选择性应用人工材料疝修补治疗嵌顿、绞窄性造口旁疝是安全可行的。

Objective To investigate the rationality and evaluation the effect of artificial synthetic materials in the open repair of parastomal hernias with incarceration or strangulation. Methods To analyze the clinical data of 6 patients with parastomal hernias with incarceration or strangulation, repaired with artifi- cial synthetic materials synchronizationally in Beijing Chaoyang Hospital from March 2006 to September 2007 retrospectively. Results All the patients were cured without death or infection of abdominal cavity. One case by preperitoneal repair with polypropylene mesh occurred infection of incisional wound, taken out of the mesh after 20 days, and was cured by normal position intraperitoneal tension-free repair. One case occurred fat colliquation in ineisional wound, and was cured by change of dressing in short time. The operation time wasl20 to 160 min （average was 130 min）, the hospital stay wasl2 to 35 d （average was 17d）. During the follow up period of 3 to 21 months （average was 11 months）, there was no inchoate recurrence. Conclusions Selective application of artificial synthetic materials in treatment of parastomal hernias with incarceration or strangulation was safe and feasible.