Carne P W G, Robertson G M, Frizelle F A
Colorectal Unit, Department of Surgery, Christchurch Hospital, Riccarton Avenue, Christchurch, New Zealand.
Br J Surg. 2003 Jul;90(7):784-93. doi: 10.1002/bjs.4220.
Parastomal hernia following formation of an ileostomy or colostomy is common. This article reviews the incidence of hernia, the technical factors related to the construction of the stoma that may influence the incidence, and the success of the different methods of repair.
A literature search using the Medline database was performed to locate English language articles on parastomal hernia. Further articles were obtained from the references cited in the literature initially reviewed.
Parastomal hernia affects 1.8-28.3 per cent of end ileostomies, and 0-6.2 per cent of loop ileostomies. Following colostomy formation, the rates are 4.0-48.1 and 0-30.8 per cent respectively. Site of stoma formation (through or lateral to rectus abdominis), trephine size, fascial fixation and closure of lateral space are not proven to affect the incidence of hernia. The role of extraperitoneal stoma construction is uncertain. Mesh repair gives a lower rate of recurrence (0-33.3 per cent) than direct tissue repair (46-100 per cent) or stoma relocation (0-76.2 per cent).
The incidence of parastomal hernia is between 0 and 48.1 per cent, depending on the type of stoma and length of follow-up. No technical factors related to the construction of the stoma have been shown to prevent herniation. If repair is required, a prosthetic mesh technique should be considered. Further randomized clinical trials (particularly of extraperitoneal stoma construction) are needed.
回肠造口术或结肠造口术后的造口旁疝很常见。本文综述了疝的发生率、与造口构建相关的可能影响发生率的技术因素，以及不同修复方法的成功率。
使用Medline数据库进行文献检索，以查找关于造口旁疝的英文文章。通过最初查阅文献中引用的参考文献获取更多文章。
造口旁疝在末端回肠造口术中的发生率为1.8% - 28.3%，在袢式回肠造口术中为0% - 6.2%。结肠造口术后，发生率分别为4.0% - 48.1%和0% - 30.8%。造口形成的部位（经腹直肌或在腹直肌外侧）、环钻大小、筋膜固定和外侧间隙的闭合未被证实会影响疝的发生率。腹膜外造口构建的作用尚不确定。补片修复的复发率（0% - 33.3%）低于直接组织修复（46% - 100%）或造口重新定位（0% - 76.2%）。
造口旁疝的发生率在0%至48.1%之间，取决于造口类型和随访时间。尚未发现与造口构建相关的技术因素可预防疝形成。如果需要修复，应考虑使用人工补片技术。需要进一步进行随机临床试验（特别是关于腹膜外造口构建的试验）。
