目的

探讨一期还纳肠造口在腹壁巨大切口疝合并肠造口患者中的可行性及安全性，以期为临床决策提供循证依据。

方法

回顾性分析2023年1—12月在郑州大学第一附属医院胃肠外科/疝和腹壁外科接受腹壁巨大切口疝修补联合造口还纳的6例患者的临床资料，分析其手术方案、近期并发症及手术效果。

结果

6例患者顺利完成肠造口还纳并腹壁疝修补术，平均手术时间为（289.2±112.4）min，平均出血量为（65.0±49.5）ml，平均住院时间为（10.8±2.0）d。术后无吻合口瘘、腹腔间室综合征、肠梗阻及补片感染等严重并发症。2例患者发生皮下血清肿，经持续引流后治愈。术后随访12～24个月，腹壁疝无复发。

结论

在严格遵循无菌操作原则并确保合理选择腹壁修补技术的前提下，一期还纳造口联合腹壁切口疝修补术在初步研究中显示出安全性及可行性，有污染风险的切口并不是一期疝修补以及补片应用的绝对禁忌证。

Objective

To evaluate the feasibility and safety of primary stoma reversal combined with giant incisional hernia repair in patients with abdominal wall giant incisional hernia and intestinal stoma， aiming to provide evidence-based guidance for clinical decision-making.

Methods

A retrospective analysis was conducted on the clinical data of 6 patients who underwent large ventral incisional hernia repair combined with stoma reversal at the Department of Gastrointestinal Surgery/Hernia and Abdominal Wall Surgery， the First Affiliated Hospital of Zhengzhou University， between January 2023 and December 2023.The surgical strategies， short-term complications， and operative outcomes were evaluated.

Results

All 6 patients successfully underwent stoma reversal combined with abdominal wall hernia repair. The average operative time was （289.2±112.4） minutes， with an average blood loss of （65.0±49.5） ml. The average hospital stay was （10.8±2.0） days. No severe postoperative complications such as anastomotic leakage，abdominal compartment syndrome， intestinal obstruction， or mesh infection occurred. Two patients developed postoperative subcutaneous seromas， which were cured after continuous drainage. During the 12-24 months of follow-up， there were no cases of incisional hernia recurrence.

Conclusion

Under strict adherence to aseptic techniques and with appropriate selection of abdominal wall reconstruction methods， the preliminary study demonstrates that single-stage stoma reversal combined with incisional hernia repair appears to be safe and feasible. Importantly， potentially contaminated surgical sites should not be considered an absolute contraindication for simultaneous hernia repair with mesh implantation.