腹腔镜下造口旁疝补片修补术可行性、安全性探讨

目的：就所开展的腹腔镜下造口旁疝补片修补术的临床资料，进行该手术可行性和安全性的探讨。方法：自2004年9月至2006年4月，我院为10例造口旁疝病人进行了腹腔镜下补片修补术。结果：10例造口旁疝病人中9例修补成功，1例因腹腔内广泛致密粘连而中转为开腹缝合修补；手术时间平均113（45～180）min：疝环大小平均5．6（4～6）cm；术后2例出现暂时性腹胀；7例修补区域腹壁疼痛，持续2周后均明显缓解：1例出现呼吸功能减退，经使用无创呼吸机辅助治疗后缓解；5例出现浆液肿，经2～4次穿刺抽液并加压包扎后治愈，无血肿发生．也未发生与手术相关的感染。术后住院时间平均5．7（3-9）d；术后随访平均9．1（2～19）个月，未见早期复发。结论：腹腔镜造口旁疝补片修补术从技术上讲是安全、可行的，从早期的临床结果来看．效果较理想。

The safety and feasibility of laparoscopic parastomal herniorraphy with meshes

Objectives To evaluate the safety and feasibility of laparoscopic herniorrhaphy with meshes in treating parastomal hernia. Methods Laparoscopic mesh repair was performed in 10 patients with parasromal hernia from Sept. 2004 to Apr. 2005. Results Laparoscopic parastomal herniorrhaphy with meshes was undergone in 10 patients; it was successful in 9 patients, and 1 case was converted to open operation because of extensive intra-peritoneal adhesion. The average operating time was 113 (45-180) min, the mean hernia defect was 5.6 cm in diameter (4-6 cm), and the average postoperative hospital stay was 5.7 (3-9) d. Seven patients complained of severe pain in the operative area, lasting for 2 weeks. One patient felt dyspnea, which ameliorated by the use of VPAP. Five patients were complicated with seroma. No wound infection or early recurrence occurred in all these 10 cases. Conclusions Laparoscopic herinorrhaphy with meshes is a safe and effective method in treating parastomal hernia.