腹腔镜和开放式修补法治疗造口旁疝的对比研究

Comparative study of laparoscopic and open repair of parastomal hernia

目的：对比分析腹腔镜与开放式修补术治疗造口旁疝的临床疗效。方法：回顾分析2006年1月至2013年12月收治的41例造口旁疝患者的临床资料,将患者随机分为腹腔镜组（n=18）与开放组（n=23）,对比分析两组患者手术时间、术后并发症、术中出血量、术后疼痛时间、住院时间及术后复发率。结果：两组患者手术时间及术后并发症差异无统计学意义（P〉0.05）,但腹腔镜组术中出血量、术后疼痛时间、术后住院时间明显优于开放组（P〈0.05）。术后随访5~17个月,平均（8.0±6.5）个月,两组均无复发病例。结论：与开放手术相比,腹腔镜手术治疗造口旁疝同样安全、有效,且具有患者创伤小、康复快、住院时间短等优点,值得临床推广应用。

Objective：To compare and analyze the clinical effect of open and laparoscopic repair of parastomal hernia. Meth- otis ：The clinical data of 41 patients with parastomal hernia from Jan. 2006 to Dec. 2013 were retrospectively analyzed. The patients were randomly divided into twb groups ： laparoscopy group （ n = 18 ） and open group （ n = 23 ）. The operative time, postoperative complica- tion,intraoperative blood loss,time of postoperative pain, postoperative hospitalization, and postoperative recurrence were compared be- tween the two groups. Results：There was no significant difference between two groups in operative time and postoperative complication （ P 〉 0.05 ）. Laparoscopic group had better results on intraoperative blood loss, time of postoperative pain, and postoperative hospitaliza- tion （ P 〈 0.05 ）. No recurrence was found in two groups during a follow-up of （ 8.0 ± 6.5 ） months （ range, 5-17 months）. Conclu- sions：Open and laparoseopic repair procedures are both safe and valid methods in treatment of parastomal hernia. Laparoscopic repair has the advantages of minimal invasion, quick recovery and short postoperative hospitalization,which is worth clinical spreading.