Division of General Surgery, The Ottawa Hospital-General Campus, Ottawa, Canada.
Colorectal Dis. 2011 Jul;13(7):e176-7. doi: 10.1111/j.1463-1318.2010.02388.x.
We describe a modified abdominoplasty technique as an alternative approach to the revision of a difficult stoma.
A patient with a retracted colostomy secondary to change in abdominal wall contour following significant weight loss was treated with this technique. The patient had previous colostomy revision with marlex mesh insertion for combined parastomal and massive ventral hernia repair. A preoperatively marked crescent shaped left upper quadrant segment of skin and subcutaneous fat was excised and the defect was approximated in multiple layers. This shifted the stoma opening cephalad and eliminated the cutaneous crease that originally made it difficult to obtain a proper stoma seal.
At one year follow up the patient was extremely satisfied with the results and was able to properly pouch the stoma.
Modified abdominoplasty can be used as an alternative, low morbid approach in dealing with selected patients with difficult stoma problems.
我们描述了一种改良的腹部整形术式，作为处理困难造口的一种替代方法。
我们对 1 例因腹壁轮廓改变导致结肠造口回缩的患者采用了该技术。该患者曾因巨大的腹侧疝和造口旁疝行结肠造口术和 Marlex 网片修补术，后出现造口回缩。术前标记的左上象限月牙形皮肤和皮下脂肪被切除，然后将缺损进行多层缝合。这样可以使造口开口向上移位，并消除原来导致造口密封困难的皮肤褶皱。
在 1 年的随访中，患者对结果非常满意，并能够正确地使用造口袋。
改良的腹部整形术可作为一种替代方法，用于处理特定的造口困难患者，其具有较低的并发症风险。
