【摘要】 目的探讨采用腹腔镜钥匙孔手术行造口旁疝修补术的可行性。方法回顾性分析2007年11月～2011年10月采用钥匙孔技术及Proceed补片完成的13例腹腔镜造口旁疝修补术的临床资料。2例回肠代膀胱造瘘,11例左下腹永久性乙状结肠造瘘,其中1例为造口旁疝修补术后复发。术中游离疝周粘连后,将补片适当修剪,中间留圆孔,置于疝囊下方,用5 mm螺旋钉枪固定于腹壁。结果所有患者均顺利完成手术。术中并发症2例:横结肠系膜血管损伤1例,造瘘肠管损伤1例;术后并发症3例:切口感染1例,血清肿2例。术后随访5～52个月,平均26个月,1例复发,1例死于肺部感染。结论采用腹腔镜钥匙孔手术及Proceed补片行腹腔镜造口旁疝修补术是安全可行的,临床疗效较为满意,在降低造口旁疝修补术后补片相关并发症发生率和复发率方面具有一定的意义。更多还原

【Abstract】 Objective To discuss the feasibility of laparoscopic parastomal hernia repair by using keyhole technique.Methods We retrospectively analyzed the clinical data of 13 patients,including 2 cases of ileostomies and 11 cases of permanent colostomies in the left lower quadrant(one of them had undergone hernia repair prior to laparoscopic parastomal hernia repair),who underwent laparoscopic parastomal repair in our hospital from November 2007 to October 2011.Keyhole technique and Proceed mesh were employed during the procedure.After adhesiolysis,a mesh was fashioned with a central keyhole for fixation to the bowel,and then the mesh was tacked to the abdominal wall with 5-mm titanium spiral nails.Results The procedure was completed in all the patients successfully.Intraoperative complications occurred in two patients,including one case of transverse mesocolon blood vessel injury and one case of stoma loop injury.Postoperative complications were reported in three patients,including one case of incisional infection,and two cases of seroma.The patients were followed up for 5 to 52 months with a mean of 26 months,during which one patient had recurrent hernia,and one patient died of pulmonary infection.Conclusions Laparoscopic parastomal hernia repair with keyhole technique and Proceed mesh is feasible,effective,and safe.With the procedure,the rates of surgical complications and recurrence are decreased.更多还原