Department of General & Colorectal Surgery, Royal Gwent Hospital, Newport, South Wales, UK.
Colorectal Dis. 2010 Oct;12(10):1049-52. doi: 10.1111/j.1463-1318.2009.02178.x.
Parastomal hernias are difficult to manage and recent attention has focused on their prevention including the use of prophylactic mesh at the time of initial surgery.
A novel 'anatomical' approach to stoma formation, the lateral rectus abdominis positioned stoma (LRAPS), involving minimal anterior abdominal wall disruption is described.
LRAPS was carried out electively (n = 25) or as an emergency (n = 4) for benign or malignant pathology. Twenty-two had a midline laparotomy and all types of stomas were fashioned. There were two early and three later deaths from advanced malignancy. No parastomal hernias have been detected at a mean follow-up of 13 (range 7-18) months and none detected by CT scanning in 20 of 24 patients with colorectal cancer at a mean follow-up of 14 (range 10-18) months.
LRAPS reduces the incidence of early stomal herniation.
造口旁疝难以处理，最近的研究重点集中在其预防上，包括在初次手术时使用预防性补片。
本文描述了一种新的“解剖学”造口方法，即侧腹肌定位造口术（LRAPS），它涉及到最小的前腹壁破坏。
LRAPS 选择性进行（n=25）或作为紧急情况进行（n=4），用于良性或恶性病变。22 例患者行中线剖腹术，所有类型的造口均成形。有 2 例早期和 3 例晚期因晚期恶性肿瘤死亡。在平均随访 13 个月（范围 7-18 个月）后，未发现造口旁疝，在平均随访 14 个月（范围 10-18 个月）的 24 例结直肠癌患者中，20 例通过 CT 扫描未发现造口旁疝。
LRAPS 降低了早期造口疝的发生率。
