摘要
［目的］寻找创伤小、效果好的造口旁疝修补方法。［方法］舌状皮瓣以腹壁上动静脉和肋间动静脉为供应血管，切口的内侧直线部分与原手术正中切口重叠，“舌尖”弧线部分近似以造口为圆心以５ｃｍ长为半径的圆弧，连接外侧直线为内侧直线的镜象对称线。沿深筋膜表面发展皮瓣便能找到疝囊、疝环即可子以修补。［结果］共施行５例，并发症有造口末端缺血坏死１例，暂时性皮瓣边缘缺血２例，造口周围皮肤凹陷１例。［结论］经舌状皮瓣切口修补造口旁疝手术创伤局限于腹壁皮下，对腹腔扰乱小，修补方便。但若因过分考虑修补牢度而清除造口周围脂肪可造成修补后造口周围皮肤凹陷及造口末端缺血坏死。
Purpose] To search a less traumatic and more effective repairable method for para - stoma hernia. [Method] The tongue- shaped flap was devised with the superior epigastric and intercostal vessels. To make the medial straight part of the flap incision overlapped with the original median incision scar. The curve part of the 'tongue tip' was similar to an arc having the circle centre of the stoma and the radius of 5cm. The lateral straight part of the incision was just the mirror symmetry to the medial straight one. Hernia sac and hernia ring could be easily found by dissecting along with deep fascia and the hernia be easily repaired as well. [Result] The operation was performed in 5 cases with the post-operative complications as following: Ischemic necrosis of the terminal of the stoma occured in one of five cases, transient marginal ischemia of the flap in two cases and sunken para-stoma skin in one case. [Conclusions] Para-stoma hernia may be repaired through a tongue-shpaed flap incision with less traumatic and disturbance to the abdomenal cavity. Sunken para-stoma skin and terminal ischemia of the stoma may be caused by removing too much fat under the repaired para - stoma for undue consideration of incision fastness.
