腹腔镜造口旁疝修补术的术式选择与并发症处理

摘要

目的 探讨腹腔镜造口旁疝修补术的术式选择,分析并发症的产生原因,并总结常见并发症的预防和处理方法.方法 回顾性分析2014年1月至2016年6月期间于中国医科大学附属盛京医院行造口旁疝修补术的25例病人的临床资料.结果 25例手术中腹腔镜辅助下Keyhole术9例、Modified Sugarbaker术 10例、Sandwich术1例、lap-re-do术7例(包括复发病例行多次手术治疗),均获成功.手术时间为63~268 min,平均手术时间为(135.84±56.70) min;术后住院时间为7~33 d,平均术后住院时间为(12.96±7.31) d.术后随访9~39个月,3例复发,1例感染,1例复发再次手术后感染,无肠瘘、慢性疼痛等其他并发症的发生.结论 造口旁疝修补术的术式选择和并发症处理要根据病人具体情况而定.%Objective To investigate the operation selection of laparoscopic parastomal hernia repair, to analyze the causes of complications, and to summarize the treatment and prevention of common complications.Methods A retrospective analysis was made on the clinical data of 25 patients undergoing parastomal hernia repair in Shengjing Hospital of China Medical University from January 2014 to June 2016.Results Twenty-five cases of parastomal hernia repair surgeries assisted by laparoscope were successfully operated, including 9 cases of Keyhole, 10 cases of Modified Sugarbaker, 1 case of Sandwich and 7 cases of lap-re-do.Among the surgeries, the recurrent cases were treated with multiple operations.The operation time was 63-268 min, with an average of (135.84±56.70) min.The postoperative hospital stay was 7-33 days, with an average of (12.96±7.31) days.The patients were followed up for 9 to 39 months.There were 3 cases of recurrence, 1 case of infection, 1 case of recurrence with infection after surgery again.The patients had no intestinal fistula, chronic pain and other complications.Conclusions The operation selection of parastomal hernia repair and the management of postoperative complications should depend on the patient's conditions.