腹腔镜Sugarbaker法治疗造口旁疝疗效评估(附37例报告)

Effect evaluation of laparoscopic Sugarbaker technique in the treatment of parastomal hernia:A report of 37 cases

目的评价采用腹腔镜Sugarbaker法进行造口旁疝修补的疗效。方法回顾性分析2013年2月至2014年12月山东大学附属省立医院收治的37例行腹腔镜Sugarbaker法修补造口旁疝病人的临床资料。均使用Physiomesh或PCO造口旁疝专用网片。分析病人术中及术后恢复情况、手术并发症、术后复发率等。结果共8例病人出现术后并发症，其中4例病人出现术后肠梗阻，2例非手术方法治愈，2例行结肠镜扩张后缓解；3例病人出现原疝囊积液，2例经超声引导穿刺抽吸后消失，1例积液并发感染，经引流、冲洗后治愈；1例有排便不畅感觉，每次排便前有腹痛，1个月后消失。随访5～26个月，中住随访时间为13个月，共发现2例病人复发，均为部分网片从边缘进入原疝囊形成复发，1例再次手术修补，l例仍在观察。结论腹腔镜Sugarbaker法修补造口旁疝安全可行，具有操作简单、复发率低等特点。

Objective To investigate the results of laparoseopie Sugarbaker technique for patients with parastomal hernia. Methods The clinical data of 37 patients with parastomal hernia treated by laparoscopic Sugarbaker technique from February 2013 to December 2014 in Provincial Hospital Affiliated to Shandong University were analyzed retrospectively. Physiomesh or PCO mesh for parastomal hernia was used in all the patients. The intraoperative and postoperative data, complications and postoperative recurrence rate were analyzed retrospectively. Results Eight patients had postoperative complications. Postoperative intestinal obstruction ocuured in 4 patients; 2 of them were cured by non operative method and 2 patients were remissioned after colonoscopy expansion. Hernia sac effusion occured in 3 patients; 2 of them disappeared after ultrasound guided aspiration and 1 case complicated with infection was cured by drainage and rinsing. One patient with impeded bowel movement, abdominal pain before each defecation, recovered 1 month later. The mean follow-up was 13 months, during which two cases of recurrence were encountered. Part of the mesh moved from the edge into the the hernial sac in both of the two recurrent patients. One case of the recurrent hernia was repaired again and the other one was still under observation. Conclusion Laparoscopie parastomal hernia repair using the Sugarbaker technique is safe and feasible in experienced surgeons. Moreover, the method has the advantages of simple operation and low recurrence rate.