腹腔镜下造口旁疝修补术

Mesh for laparoscopic repair of parastomal hernia

目的探讨腹腔镜下应用补片行造口旁疝修补术的方法、安全性及临床效果。方法2004年11月至2006年4月对6例造口旁疝进行腹腔镜补片疝修补术。结果 6例均在腹腔镜下行腹腔粘连松解和补片固定,顺利完成造口旁疝修补手术。手术时间65～130 min,平均90 min。术后住院6～9 d,平均7 d。术后疼痛达3个月以上者有2例;浆液肿2,经穿刺抽液和加压包扎后治愈。无手术死亡,无造口感染和肠瘘发生。随访7～26个月,平均13个月,未见造口旁疝复发。结论腹腔镜下行腹腔内粘连松解、采用腔内缝合器固定补片来修补造口旁疝是一种安全、有效的微创方法,值得临床推广应用。

Objective To investigate the value of mesh in laparoscopic repair of parastomal hernia. Methods Laparoscopic repair with mesh was performed in 6 patients with parasromal hernia from December 2004 to April 2006 in this hospital. Results Laparoscopic mesh herniorrhaphy was successfully performed in 6 patients. The operative time was 65～130 minites (average 90 min). Postoperative hospital stay was 6～9 days(average 7 days). Two patients complained of persistent pain for three months and two patients had seroma ,which was cured by needle aspiration and pressure bandage . No death and intestinal fistula nor infection occurred postoperatively. No recurrence of hernia was observed in all patients in 7 to 26 months(average 13 months) during follow-up. Conclusions Laparoscopic parastomal hernia repair using mesh is a safe and effective procedure of less injury to tissues.