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肠造口旁疝修补术:腹腔镜下腹膜前疝补片成形术联合造口转移。现状及临床病例报告。

Parastomal hernia repair: laparoscopic ventral hernia meshplasty with stoma relocation. The current state and a clinical case presentation.

机构信息

Department of Surgery, Hospital de Conxo, Complejo Hospitalario Universitario de Santiago, C/Ramón Baltar, s/n. 15706, Santiago de Compostela, Spain.

出版信息

Hernia. 2011 Feb;15(1):85-91. doi: 10.1007/s10029-009-0617-8. Epub 2010 Jan 19.

DOI:10.1007/s10029-009-0617-8
PMID:20084419
Abstract

BACKGROUND

Parastomal hernia is a frequent complication after performing an ostomy, and although different technical options have been described, it lacks an ideal intervention to resolve it. The use of meshes and the laparoscopic approach, has led to a significant advance in resolving this condition. However, the ideal technique should guarantee must ensure integral repair of the abdominal wall, taking into account the functionality of the stoma. In large parastomal eventrations the repairing of the ventral hernia with a mesh and relocating the stoma in another quadrant may be an intervention that fulfills both principles, and open approach being described.

METHODS

We review the current state of surgical management of this condition and analyze the different technical options. Present the first description for using a laparoscopic technique with meshplasty and stoma relocation in an obese patient with a complex parastomal hernia, with results in the 18 month follow up.

CONCLUSIONS

Surgical technique repair of the parastomal hernia is sometimes a complex issue, which possibly requires different solutions according to the characteristics of the hernia and patient. The technique described of meshplasty with stoma relocation by laparoscopic approach has been revealed as an affordable technique, with minor inconvenience to the patient, absence of complications and good functional results in the long term, benefiting from the advantages of minimally invasive surgery itself.

摘要

背景

造口术后发生肠造口旁疝是一种常见的并发症,虽然已经描述了不同的技术选择,但仍缺乏理想的干预方法来解决它。使用网片和腹腔镜方法,在解决这种情况方面取得了重大进展。然而,理想的技术应该保证腹壁的完整修复,同时考虑到造口的功能。在大型肠造口旁疝中,使用网片修复腹疝并将造口转移到另一个象限可能是一种满足这两个原则的干预措施,我们将对其进行描述。

方法

我们回顾了目前对这种情况的手术治疗方法,并分析了不同的技术选择。介绍了首例在肥胖患者中使用腹腔镜技术进行网片成形和造口转移治疗复杂肠造口旁疝的病例,并在 18 个月的随访中报告了结果。

结论

肠造口旁疝的手术修复有时是一个复杂的问题,可能需要根据疝和患者的特点采用不同的解决方案。通过腹腔镜方法进行的网片成形和造口转移的技术已被证明是一种可行的技术,对患者的不便较小,无并发症,长期功能结果良好,受益于微创外科本身的优势。

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本文引用的文献

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Parastomal hernia-repair using mesh and an open technique.使用补片和开放技术进行造口旁疝修补术。
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Laparoscopic parastomal hernia repair.腹腔镜造口旁疝修补术
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