目的

探讨双腔造瘘口旁疝诊疗经验。

方法

收集2020 年6 月至2024 年6 月北京朝阳医院疝和腹壁外科行手术治疗双腔造瘘口旁疝的20 例患者的临床资料。收集并分析患者性别、年龄、住院时间、入院主诉、入院诊断、手术方式、手术时间、术后并发症在内的基本资料及治疗资料。

结果

本组患者均顺利完成手术，其中接受腹腔镜联合开腹手术治疗患者17 例，完全腹腔镜手术治疗患者2 例，完全开放手术治疗患者1 例。手术患者中先行造瘘肠管还纳8 例：还纳后行IPOM术式修补腹壁缺损3 例、开放手术行Sublay 修补1 例、原位单纯缝合修补后移位行结肠永久性造瘘4 例。于术中将双腔造瘘重建为单腔造瘘后再行疝修补患者9 例，其中行Sugarbaker 术式5 例、Keyhole 1 例、单纯缝合修补3 例。行保留双腔造瘘的腹腔镜造瘘口旁疝修补3 例。

结论

双腔造瘘口旁疝的推荐治疗方案包括造瘘还纳后腹壁修补、更改为单腔造瘘行疝修补、保留双腔造瘘的造瘘口旁疝修补术。手术推荐腹腔镜下放置补片修补腹壁缺损。

Objective

To explore the experience in treatment of double lumen parastomal hernia.

Methods

Collect clinical data of 20 patients who underwent surgical treatment for double lumen parastomal hernia in the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital from June 2020 to June 2024. Collect and analyze basic information and treatment data, including gender,age, length of hospital stay, chief complaint, diagnosis, surgical method, duration of surgery, and postoperative complications.

Results

All patients in this group successfully completed the surgery.Among them, 17 cases underwent laparoscopic combined with open surgery, 2 cases underwent complete laparoscopic surgery, and 1 case underwent complete open surgery. Eight cases underwent loop ileostomy stoma closure first: 3 cases underwent IPOM repair, 1 case underwent open surgery for Sublay repair, and 4 cases underwent displaced permanent colostomy with simple suturing repair. Nine patients underwent reconstruction of double lumen stoma into single lumen stoma before hernia repair, including 5 cases of Sugarbaker repair, 1 case of Keyhole repair, and 3 cases of simple suture repair. Three patients underwent laparoscopic repair of hernia while preserving the double lumen stoma.

Conclusion

The recommended treatment options for double lumen parastomal hernia include hernia repair after the stoma closure,changing to single lumen stoma for hernia repair, and retaining the double lumen stoma for hernia repair.Surgical recommendation is to place a mesh under laparoscopy to repair abdominal wall defects.