腹腔镜腹膜外结肠造口术初始阶段的安全性：神奈川横滨结直肠癌研究组（KYCC）1804的一项前瞻性观察研究
The safety of laparoscopic extraperitoneal colostomy in the introductory phase: A prospective observational study by the Kanagawa Yokohama Colorectal Cancer Study Group (KYCC) 1804.
作者信息
Higuchi Akio, Numata Masakatsu, Saeki Hiroyuki, Izukawa Shota, Nukada Suguru, Iguchi Kenta, Uchiyama Mamoru, Okamoto Hironao, Atsumi Yosuke, Kato Aya, Kazama Keisuke, Suzuki Shinsuke, Katayama Yusuke, Numata Koji, Sawazaki Sho, Tamagawa Hiroshi, Sugano Nobuhiro, Godai Teni, Mushiake Hiroyuki, Shinoda Satoru, Matsumoto Satomi, Rino Yasushi, Saito Aya, Shiozawa Manabu
机构信息
Department of Gastrointestinal Surgery, Yokohama Minami Kyousai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama City, Kanagawa, 236-0037, Japan.
Department of Gastroenterological Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan.
出版信息
Surg Today. 2025 Mar 26. doi: 10.1007/s00595-025-03020-2.
PURPOSE
To assess the incidence of parastomal hernia in the introductory phase following laparoscopic extraperitoneal colostomy.
METHODS
The subjects of this observational study were 30 patients who underwent laparoscopic extraperitoneal sigmoid colostomy between April 2019 and November 2020. We evaluated the incidence of parastomal hernia over 2 years and the time required for stoma creation.
RESULTS
Parastomal hernia was diagnosed in five patients (17.2%), which was a higher incidence than that reported previously (0-13.3%). An exploratory analysis using the LASSO logistic regression model identified obesity (body mass index ≥25 kg/m) and postoperative wound dehiscence as risk factors for parastomal hernia. The mean stoma creation time was 23.6 min, with >80% of cases completed within 30 min.
CONCLUSION
Laparoscopic extraperitoneal colostomy can be adopted successfully, even in centers without prior experience. However, the incidence of parastomal hernia in this study was slightly higher than reported previously. Obese patients had longer stoma creation times and a higher incidence of parastomal hernia.
目的
评估腹腔镜腹膜外结肠造口术后初始阶段造口旁疝的发生率。
方法
本观察性研究的对象为2019年4月至2020年11月期间接受腹腔镜腹膜外乙状结肠造口术的30例患者。我们评估了2年内造口旁疝的发生率以及造口形成所需的时间。
结果
5例患者（17.2%）被诊断为造口旁疝，这一发生率高于先前报道的发生率（0 - 13.3%）。使用LASSO逻辑回归模型进行的探索性分析确定肥胖（体重指数≥25 kg/m²）和术后伤口裂开是造口旁疝的危险因素。造口形成的平均时间为23.6分钟，超过80%的病例在30分钟内完成。
结论
即使在没有先前经验的中心，腹腔镜腹膜外结肠造口术也能成功采用。然而，本研究中造口旁疝的发生率略高于先前报道。肥胖患者造口形成时间更长，造口旁疝的发生率更高。
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