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造口旁疝——当前的认识与治疗

Parastomal hernia - current knowledge and treatment.

作者信息

Styliński Roman, Alzubedi Adam, Rudzki Sławomir

机构信息

Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Lublin, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2018 Mar;13(1):1-8. doi: 10.5114/wiitm.2018.72685. Epub 2018 Jan 16.

Abstract

Intestinal stoma creation is one of the most common surgical procedures. The most common long-term complication following stoma creation is parastomal hernia, which according to some authors is practically unavoidable. Statistical differences of its occurrence are mainly due to patient observation time and evaluation criteria. Consequently, primary prevention methods such as placement of prosthetic mesh and newly developed minimally invasive methods of stoma creation are used. It seems that in the light of evidence-based medicine, the best way to treat parastomal hernia is the one that the surgeon undertaking therapy is the most experienced in and is suited to the individuality of each patient, his condition and comorbidities. As a general rule, reinforcing the abdominal wall with a prosthetic mesh is the treatment of choice, with a low rate of complications and relapses over a long period of time. The current trend is to use lightweight, large pore meshes.

摘要

肠道造口术是最常见的外科手术之一。造口术后最常见的长期并发症是造口旁疝,一些作者认为这几乎是不可避免的。其发生率的统计学差异主要归因于患者的观察时间和评估标准。因此,人们采用了诸如放置人工补片等一级预防方法以及新开发的微创造口术方法。从循证医学的角度来看,治疗造口旁疝的最佳方法似乎是进行治疗的外科医生最有经验且适合每个患者的个体情况、病情及合并症的方法。一般来说,用人工补片加强腹壁是首选的治疗方法,其并发症发生率低且长期复发率低。目前的趋势是使用轻质、大孔径的补片。

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