Nagy Attila, Jánó Zoltán
Veszprém Megyei Csolnoky Ferenc Kórház Általános Sebészeti Osztály 8200 Veszprém Kórház u. 1.
Magy Seb. 2010 Oct;63(5):335-9. doi: 10.1556/MaSeb.63.2010.5.7.
The overall incidence of parastomal hernias is 35-50%. Different methods of hernia repairs (local fascial repair, stoma relocation and various types of mesh repairs) did not provide satisfactory results. Laparoscopic approach makes peristomal incision unnecessary and decreases the potential risk of mesh infection as well. In spite of all attempts the incidence of recurrent parastomal hernias is as high as 12-35%. These unsatisfactory results supported the idea of mesh implantation at the time of the initial stoma formation. In this study the authors inserted a self-designed two-layered special meshin 17 cases as a prevention and after 5 years follow-up period no parastomal hernias were recorded. The only complication noted was a minor stricture on the surface of the skin, that could have easily been corrected. Therefore, the authors support the idea of preventive mesh insertion at time of definitive stoma formation.
造口旁疝的总体发生率为35% - 50%。不同的疝修补方法(局部筋膜修补、造口移位和各种类型的补片修补)均未取得令人满意的效果。腹腔镜手术无需进行造口周围切口,也降低了补片感染的潜在风险。尽管采取了各种措施,复发性造口旁疝的发生率仍高达12% - 35%。这些不尽人意的结果支持了在初次造口形成时植入补片的想法。在本研究中,作者为17例患者植入了自行设计的两层特殊补片作为预防措施,经过5年的随访期,未记录到造口旁疝。唯一观察到的并发症是皮肤表面轻微狭窄,很容易得到纠正。因此,作者支持在永久性造口形成时预防性植入补片的观点。