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中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 452 -455. doi: 10.3877/cma.j.issn.1674-392X.2019.05.017

所属专题: 文献

临床论著

经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中的应用
朱林榆1, 张瑜1, 冷少龙1,()   
  1. 1. 518000 深圳,中山大学附属第七医院
  • 收稿日期:2019-03-07 出版日期:2019-10-18
  • 通信作者: 冷少龙

Experience in application of ipsilateral rectus abdominis translocation stoma in laparoscopic parastomal hernia repair

Linyu Zhu1, Yu Zhang1, Shaolong Leng1,()   

  1. 1. The seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518000, China
  • Received:2019-03-07 Published:2019-10-18
  • Corresponding author: Shaolong Leng
  • About author:
    Corresponding author: Leng Shaolong, Email:
引用本文:

朱林榆, 张瑜, 冷少龙. 经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(05): 452-455.

Linyu Zhu, Yu Zhang, Shaolong Leng. Experience in application of ipsilateral rectus abdominis translocation stoma in laparoscopic parastomal hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(05): 452-455.

目的

分析经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中的应用价值。

方法

选取2016年8月至2017年12月,重庆市开州区中医院收治的60例乙状结肠造口旁疝患者,随机分为对照组和观察组,每组30例。对照组行开放造口旁疝修补术,观察组行腹腔镜经同侧腹直肌易位造口修补术。比较2组患者手术和住院情况、并发症发生率、复发率、远期疼痛发生率及切口疝发生率。

结果

观察组患者感染发生率、并发症总发生率及复发率分别为0、16.67%及3.33%,明显低于对照组16.67%、43.33%及23.33%,差异有统计学意义(χ2=5.455、5.079、5.192,P=0.020、0.024、0.023)。观察组患者手术时间、住院费用分别为(131.05±12.11)min、(38 946.06±1 019.75)元均高于对照组(96.91±10.54)min、(18 492.19±572.36)元,差异有统计学意义(t=11.647、95.802,P均<0.001)。观察组患者术中出血量、术后下床活动时间及术后恢复活动时间分别为(33.14±8.06)ml、(1.26±0.51)d、(3.59±1.17)d均低于对照组(69.28±9.18)ml、(2.27±1.02)d、(5.44±2.25)d,差异有统计学意义(t=16.204、4.851、3.996,P均<0.001)。

结论

经同侧腹直肌易位造口在腹腔镜造口旁疝修补术中应用效果较好,能够有效改善乙状结肠造口旁疝患者手术情况及住院情况,减少术后并发症的发生和疝复发。

Objective

To analyze the application value of ipsilateral rectus abdominis translocation stoma in laparoscopic parastomal hernia repair.

Methods

60 patients with parasagiostomy hernia admitted to Kaizhou district hospital were randomly divided into the control group and the observation group, with 30 cases in each group. Patients in the control group were treated with open parastomal hernia repair, while patients in the observation group were treated with laparoscopic parastomal hernia repair with stoma relocation trans-ispilateral rectus abdominis. The operation, hospitalization, complication rate, recurrence rate, long-term pain rate and incisional hernia rate were compared between the two groups.

Results

The incidence of infection, total incidence of complications and recurrence rate in the observation group were 0%, 16.67% and 3.33%, respectively, which were significantly lower than those in the control group (16.67%, 43.33% and 23.33%), with statistical differences (χ2=5.455、5.079、5.192, P=0.020、0.024、0.023). The operation time and hospitalization expenses of patients in the observation group were higher than those in the control group, with statistical differences [(131.05±12.11) min vs (96.91±10.54) min, (38 946.06±1 019.75) yuan vs (18 492.19±572.36) yuan, t=11.647、95.802, all P<0.001]. The patients in the observation group had lower intraoperative bleeding, postoperative ambulation time and postoperative recovery time than those in the control group, with statistical differences [(33.14±8.06) ml vs (69.28±9.18) ml, (1.26±0.51) d vs (2.27±1.02) d, (3.59±1.17) d vs (5.44±2.25) d, t=16.204、4.851、3.996, all P<0.001].

Conclusion

Ipsilateral rectus abdominis translocation stoma has good effect in laparoscopic parastomal hernia repair. It can effectively improve the operation and hospitalization, and reduce the postoperative complications and recurrence in patients with parastomal hernia of sigmoid colon, which is worthy for clinical application.

表1 2组患者围手术期指标比较(±s
表2 2组患者住院指标比较(±s
表3 2组间并发症比较[例(%)]
表4 2组复发、慢性疼痛、切口疝情况比较[例(%)]
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