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腹腔镜下 Sugarbaker 修补术治疗根治性膀胱切除术和回肠导管术后的造口旁疝:单中心经验。

Laparoscopic Sugarbaker repair of parastomal hernia following radical cystectomy and ileal conduit: a single-center experience.

机构信息

Department of General Surgery, Huashan Hospital, Fudan University, Wulumuqi Mid Road 12, Jing'an District, Shanghai, 200040, China.

Center for Obesity and Hernia Surgery, Huashan Hospital, Fudan University, Wulumuqi Mid Road 12, Jing'an District, Shanghai, 200040, China.

出版信息

BMC Surg. 2024 Sep 12;24(1):258. doi: 10.1186/s12893-024-02553-6.

Abstract

PURPOSE

Parastomal hernia (PH) is a frequent complication following radical cystectomy and ileal conduit. The purpose of this study was to summarize the clinical experience and technical characteristics of laparoscopic Sugarbaker repair of PH following radical cystectomy and ileal conduit.

METHODS

We retrospectively evaluated all patients who underwent laparoscopic treatment of PH following radical cystectomy and ileal conduit at Huashan Hospital, Fudan University from May 2013 to December 2022.

RESULTS

Thirty-five patients were included in the study. Median follow up was 32months (IQR, 25-38 months). Three patients presented with a recurrence (8.6%), with a median time to recurrence of 14 months. Out of the 35 patients, Thirty-two underwent totally laparoscopic repair using the Sugarbaker technique, Three patients required open surgery to repair the intestinal injury after laparoscopic exploration. One patient died 9 months post-surgery due to COVID-19. During the follow-up period, two patients developed a peristomal abscess, and one patient experienced partial intestinal obstruction 10 days after surgery.

CONCLUSION

Surgical management of PH following radical cystectomy and ileal conduit is challenging. The laparoscopic Sugarbaker technique for repairing PH following radical cystectomy and ileal conduit has low complication and recurrence rate.

摘要

目的

粪瘘(PH)是根治性膀胱切除术和回肠导管术后的常见并发症。本研究旨在总结根治性膀胱切除和回肠导管术后腹腔镜下 Sugarbaker 修复 PH 的临床经验和技术特点。

方法

我们回顾性评估了 2013 年 5 月至 2022 年 12 月在复旦大学华山医院接受根治性膀胱切除和回肠导管术后腹腔镜治疗 PH 的所有患者。

结果

研究纳入 35 例患者。中位随访时间为 32 个月(IQR,25-38 个月)。3 例患者出现复发(8.6%),复发中位时间为 14 个月。35 例患者中,32 例行完全腹腔镜下 Sugarbaker 技术修复,3 例患者在腹腔镜探查后需要开放手术修复肠损伤。1 例患者术后 9 个月因 COVID-19 死亡。随访期间,2 例患者发生粪瘘脓肿,1 例患者术后 10 天发生部分肠梗阻。

结论

根治性膀胱切除术和回肠导管术后 PH 的手术治疗具有挑战性。腹腔镜下 Sugarbaker 技术治疗根治性膀胱切除和回肠导管术后 PH 的并发症和复发率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d9/11391624/5fd1906d485e/12893_2024_2553_Fig1_HTML.jpg

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