关于降低造瘘口旁疝修补术后复发率的研究进展

Research progress on reducing the recurrence rate after parastomal hernia repair

造口旁疝是常见的外科疾病,严重影响造口患者的生活质量和身体健康。目前造口旁疝外科手术修补方式主要有Keyhole、Sugarbaker及Sandwich等方法。由于患者腹腔压力增加、腹壁肌肉筋膜薄弱、外科手术技术、修补方法及修补材料等诸多方面因素的影响,使得造口旁疝修补术后复发率高于其他腹壁疝修补术后的复发率。在造口旁疝的外科治疗和降低复发率方面需要多方面研究和探讨,导致造口旁疝复发的重要因素包括Keyhole修补方法中补片预留造口的大小及补片的皱缩等因素的控制;在Sugarbaker修补方法中补片的确切固定问题、覆盖造口肠管补片远期对肠管结构和功能影响的问题等。通过对这些修补技术和材料的研究改进,有助于提高造口旁疝的治疗效果和降低造口旁疝修补术后复发率。

Parastomal hernia is a common surgical disease,which seriously affects the quality of life and physical health of stoma patients.At present,the main surgical repair methods of parastomal hernia include Keyhole,Sugarbaker and Sandwich.Due to the increase in abdominal pressure,abdominal wall muscle fascia weakness and other physical factors,surgical techniques,repair methods,repair materials and many other factors,the recurrence rate after the parastomal hernia repair is higher than that after other abdominal wall hernia repair.Many aspects need to be studied and discussed in the surgical treatment of parastomal hernia and reducing the recurrence rate.The important factors of parastomal hernia recurrence include:in Keyhole repair method,the size of the mesh reserved for the stoma,the wrinkle of the mesh and control for other factors;in Sugarbaker repair method,the exact fixation problem of mesh,long-term effects of mesh on the structure and function of stoma colon or intestine,etc.Research and improvement of these repair techniques and materials can contribute to improve the therapeutic effect of parastomal hernia and reduce the recurrence rate after parastomal hernia repair.