Rosch R, Conze J, Junge K, Neumann U
Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinik der RWTH Aachen, Deutschland.
Chirurg. 2010 Nov;81(11):982-7. doi: 10.1007/s00104-010-1932-4.
The reparation of parastomal hernias and their recurrence remain problematic although the implementation of mesh techniques has lowered recurrences rates. Conventional surgical techniques include suture repair, relocation of the stoma as well as diverse hernia repair procedures with mesh implantation. Suture repair has been abandoned due to its high recurrence rate. Simple relocation is not recommended because of high rates of recurrent parastomal hernias. Conventional hernia repair using mesh implants is classified according to the mesh position into epifascial (onlay), retromuscular (sublay) and intraperitoneal (IPOM) techniques. Furthermore, a combination of relocation with additional mesh enforcement is also possible. The value of the different mesh techniques and of new biological mesh prostheses must be evaluated in randomized controlled studies.
尽管采用补片技术已降低了复发率,但造口旁疝的修复及其复发问题仍然存在。传统的外科技术包括缝合修补、造口重新定位以及各种带补片植入的疝修补手术。由于缝合修补复发率高,已被摒弃。单纯重新定位因造口旁疝复发率高而不被推荐。使用补片植入的传统疝修补术根据补片位置可分为筋膜上(覆盖)、肌后(下层)和腹膜内(IPOM)技术。此外,也可将重新定位与额外的补片加强相结合。不同补片技术和新型生物补片假体的价值必须在随机对照研究中进行评估。