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中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 342 -345. doi: 10.3877/cma.j.issn.1674-392X.2020.04.005

所属专题: 文献

临床论著

生物补片在合并造口旁疝的肠造口还纳术中的应用
江志鹏1, 侯泽辉1, 甘文昌1, 马宁1, 李英儒1, 曾兵1, 周太成1, 陈双1,()   
  1. 1. 510655 广州,中山大学附属第六医院胃肠、疝与腹壁外科
  • 收稿日期:2020-05-28 出版日期:2020-08-18
  • 通信作者: 陈双

Application of biological mesh in stoma reversal with parastomal hernia

Zhipeng Jiang1, Zehui Hou1, Wenchang Gan1, Ning Ma1, Yingru Li1, Bing Zeng1, Taicheng Zhou1, Shuang Chen1,()   

  1. 1. Department of Gastrointestinal and Hernia Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
  • Received:2020-05-28 Published:2020-08-18
  • Corresponding author: Shuang Chen
  • About author:
    Corresponding author: Chen Shuang, Email:
引用本文:

江志鹏, 侯泽辉, 甘文昌, 马宁, 李英儒, 曾兵, 周太成, 陈双. 生物补片在合并造口旁疝的肠造口还纳术中的应用[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(04): 342-345.

Zhipeng Jiang, Zehui Hou, Wenchang Gan, Ning Ma, Yingru Li, Bing Zeng, Taicheng Zhou, Shuang Chen. Application of biological mesh in stoma reversal with parastomal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(04): 342-345.

目的

探讨生物补片在合并造口旁疝的肠造口还纳术中的应用价值。

方法

回顾分析2017年5月10日至2019年9月30日中山大学附属第六医院,应用生物补片(SIS)在合并造口旁疝的肠造口还纳术中进行一期修补的22例患者的临床资料,观察造口部位切口疝(SSIH)的发生率及术后疼痛、血清肿、补片感染等并发症发生率。

结果

所有手术均顺利完成,Onlay修补16例,Sublay修补6例。仅1例(4.5%)出现SSIH(Onlay修补),术后疼痛以轻-中度为主,1周内基本回复正常,无血清肿、补片感染病例。Onlay与Sublay修补在SSIH发生率和其他并发症发生率方面差异无统计学意义。

结论

应用生物补片在合并造口旁疝的肠造口还纳手术中加强筋膜缺损,在不明显增加手术并发症的情况下能显著降低SSIH的发生率,是一安全、有效的方法。

Objective

To investigate the application value of biological mesh in stoma reversal with parastomal hernia.

Methods

From May 10, 2017 to September 30, 2019, the clinical data of 22 patients who underwent primary repair by using biological mesh (SIS) in stoma reversal with parastomal hernia were retrospectively analyzed. The incidence of stoma site incisional hernia(SSIH) and the incidence of postoperative pain, seroma, patch infection and other complications were observed.

Results

All operations were successfully completed, including onlay repair in 16 cases and sublay repair in 6 cases. Only 1 case (4.5%) had SSIH (onlay repair). The postoperative pain was mainly mild to moderate, and returned to normal within 1 week. There was no case of seroma or patch infection. There was no significant difference between onlay and sublay in the incidence of SSIH and other complications.

Conclusion

It is a safe and effective method to strengthen fascial defect in stoma reversal with parastomal hernia by using biological patch, without increasing the complications of operation significantly.

[1]
Lambrichts DPV, de Smet GHJ, van der Bogt RD, et al. Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta-analysis[J]. Colorectal Dis, 2018, 20(10): 0288-0303.
[2]
Bhangu A, Fletcher L, Kingdon S, et al. A clinical and radiological assessment of incisional hernias following closure of temporary stomas[J]. Surgeon, 2012, 10: 321-325.
[3]
Bhangu A, Nepogodiev D, Futaba K. Systematic review and meta-analysis of the incidence of incisional hernia at the site of stoma closure[J]. World J Surg, 2012, 36: 973-983.
[4]
Amelung FJ, de Guerre LEVM, Consten ECJ, et al. Incidence of and risk factors for stoma-site incisional herniation after reversal[J]. BJS Open, 2018, 2: 128-134.
[5]
Deerenberg EB, Harlaar J, Steyerberg EW, et al. Small bites versus large bites for closure of abdominal midline incisions(STITCH): a double-blind, multicentre, randomised controlled trial[J]. Lancet, 2015, 386: 1254-1260.
[6]
Kuhry E, Schwenk WF, Gaupset R, et al. Long-term results of laparoscopic colorectal cancer resection[J]. Cochrane Database Syst Rev, 2008(2): CD003432.
[7]
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional[J]. Lancet, 2003, 362: 1561-1571.
[8]
DuBay DA, Choi W, Urbanchek MG, et al. Incisional herniation induces decreased abdominal wall compliance via oblique muscle atrophy and fibrosis[J]. Ann Surg, 2007, 245(1): 140-146.
[9]
中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 腹壁切口疝诊断和治疗指南(2018年版)[J/CD]. 中华疝和腹壁外科杂志(电子版), 2018, 12(4): 241-243.
[10]
Nguyen MH, Pittas F. How large should a skin trephine be for an end stoma?[J]. Aust N Z J Surg, 1999, 69(9): 675-676.
[11]
Pilgrim CH, Mclntyre R, Bailey M. Prospective audit of parastomal hernia: prevalence and associated comorbidities[J]. Dis Colon Rectum, 2010, 53(1): 71-76.
[12]
Antoniou SA, Agresta F, Garcia Alamino JM, et al. European Hernia Society guidelines on prevention and treatment of parastomal hernias[J]. Hernia, 2018, 22(1): 183-198.
[13]
Carne PW, Robertson GM, Frizelle FA. Parastomal hernia[J]. Br J Surg, 2003, 90(7): 784-793.
[14]
Itani KM, Rosen M, Vargo D, et al. Prospective study of single-stage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study[J]. Surgery, 2012, 152(3): 498-505.
[15]
Hammond TM, Huang A, Prosser K, et al. Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study[J]. Hernia, 2008, 12(5): 475-481.
[16]
Serra-Aracil X, Bomvardo-Junca J, Moreno-Matias J, et al. Randomized, controlled, prospective trial of the use of a mesh to prevent parastomal hernia[J]. Ann Surg, 2009, 249(4): 583-587.
[17]
Timmermans L, De Goede B, Van Dijk S M, et al. Meta-analysis of sublay versus onlay mesh repair in incisional hernia surgery[J]. Am J Surg, 2014, 207(6): 980-988.
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