经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中的应用

目的分析经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中的应用价值。 方法选取2016年8月至2017年12月，重庆市开州区中医院收治的60例乙状结肠造口旁疝患者，随机分为对照组和观察组，每组30例。对照组行开放造口旁疝修补术，观察组行腹腔镜经同侧腹直肌易位造口修补术。比较2组患者手术和住院情况、并发症发生率、复发率、远期疼痛发生率及切口疝发生率。 结果观察组患者感染发生率、并发症总发生率及复发率分别为0、16.67%及3.33%，明显低于对照组16.67%、43.33%及23.33%，差异有统计学意义（χ²=5.455、5.079、5.192，P=0.020、0.024、0.023）。观察组患者手术时间、住院费用分别为（131.05±12.11）min、（38 946.06±1 019.75）元均高于对照组（96.91±10.54）min、（18 492.19±572.36）元，差异有统计学意义（t=11.647、95.802，P均<0.001）。观察组患者术中出血量、术后下床活动时间及术后恢复活动时间分别为（33.14±8.06）ml、（1.26±0.51）d、（3.59±1.17）d均低于对照组（69.28±9.18）ml、（2.27±1.02）d、（5.44±2.25）d，差异有统计学意义（t=16.204、4.851、3.996，P均<0.001）。 结论经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中应用效果较好，能够有效改善乙状结肠造口旁疝患者手术情况及住院情况，减少术后并发症的发生和疝复发。

Experience in application of ipsilateral rectus abdominis translocation stoma in laparoscopic parastomal hernia repair

ObjectiveTo analyze the application value of ipsilateral rectus abdominis translocation stoma in laparoscopic parastomal hernia repair. Methods60 patients with parasagiostomy hernia admitted to Kaizhou district hospital were randomly divided into the control group and the observation group, with 30 cases in each group. Patients in the control group were treated with open parastomal hernia repair, while patients in the observation group were treated with laparoscopic parastomal hernia repair with stoma relocation trans-ispilateral rectus abdominis. The operation, hospitalization, complication rate, recurrence rate, long-term pain rate and incisional hernia rate were compared between the two groups. ResultsThe incidence of infection, total incidence of complications and recurrence rate in the observation group were 0%, 16.67% and 3.33%, respectively, which were significantly lower than those in the control group (16.67%, 43.33% and 23.33%), with statistical differences (χ²=5.455、5.079、5.192, P=0.020、0.024、0.023). The operation time and hospitalization expenses of patients in the observation group were higher than those in the control group, with statistical differences (131.05±12.11) min vs (96.91±10.54) min, (38 946.06±1 019.75) yuan vs (18 492.19±572.36) yuan, t=11.647、95.802, all P<0.001]. The patients in the observation group had lower intraoperative bleeding, postoperative ambulation time and postoperative recovery time than those in the control group, with statistical differences (33.14±8.06) ml vs (69.28±9.18) ml, (1.26±0.51) d vs (2.27±1.02) d, (3.59±1.17) d vs (5.44±2.25) d, t=16.204、4.851、3.996, all P<0.001]. ConclusionIpsilateral rectus abdominis translocation stoma has good effect in laparoscopic parastomal hernia repair. It can effectively improve the operation and hospitalization, and reduce the postoperative complications and recurrence in patients with parastomal hernia of sigmoid colon, which is worthy for clinical application.