腹腔镜下造口旁疝补片修补术应用体会

目的探讨腹腔镜下造口旁疝修补术的临床效果。方法回顾性分析2007年9月至2010年4月期间8例行腹腔镜下造瘘口旁疝补片修补术患者的临床资料,分析手术情况、术后并发症及复发情况。结果 8例造口旁疝患者均在腹腔镜下修补成功。手术时间50～180min,平均135min。疝环大小4.5～6.5cm,平均5.0cm。术后1例出现肠梗阻及复发,后行腹腔镜探查及再次修补术。2例术后早期出现腹胀,1周后腹胀缓解。1例术后出现术区疼痛不适,对症治疗后缓解。本组未发生术区感染。住院时间5～14d,平均7.6d。术后随访1年,除1例复发后行再次手术外,均未见复发。结论腹腔镜下造口旁疝修补术如果注意操作要点,可以替代传统修补术。

Clinical experience of laparoscopic mesh repair of parastomal hernia

Objective To investigate the patients of laparoscopic mesh repair of parastomal hernia.Methods To investigate 8 patients of laparoscopic mesh repair of parastomal hernia from September 2007 to April 2010.To evaluate procedure,the postoperative complications and recurrence.Results Laparoscopic mesh repair of parastomal hernia was successfully performed in 8 patients.The mean operating time was 135 min.The mean hernia defect was 5.0 cm in diameter（4.5-6.5） cm.One recurrence and intestinal obstruction occurred in these 8 cases,and was cured by laparoscopic repair.Two patients had temporary abdominal distention,and had well recovered after a week.One patient complained of painfulness around the operative field,and had well recovered after symptomatic treatment.No wound infection in all these 8 cases.The average postoperative hospital stay was 7.6 d.Postoperative follow-up for 12 months revealed no recurrence except one early recurrence.Conclusions Laparoscopic mesh repair of parastomal hernia can replace the traditional repair method if pay attention to operation point.