探究结肠造口还纳术联合生物补片置入术预防造口部位切口疝发生的临床应用。

分析2022年1月至2023年12月南京鼓楼医院结直肠外科行结肠造口还纳联合生物补片置入术患者的临床资料，统计手术时间、术中出血量、术后住院时间、随访时间等，观察原造口部位切口疝（SSIH）发生率，术后切口感染、补片感染、血肿、血清肿、腹腔出血、腹腔脏器副损伤、术区淤血、术区异物感、术区疼痛感、尿潴留等。

共纳入患者18例，所有患者均于肌筋膜前放置补片（Onlay法），手术顺利，术后疼痛感均在可控范围内（口服药物或静脉注射止痛），3 d后明显好转，7 d左右基本正常，所有患者均无SSIH、切口感染、补片感染、血肿、腹腔出血、腹腔脏器副损伤、术区淤血、术区异物感、尿潴留发生；1例患者出现血清肿，局部引流管留置1周后好转，并顺利拔管出院，后续恢复良好。

结肠造口还纳联合生物补片置入术预防SSIH的发生是安全有效的，对于此类患者可考虑临床应用。

To investigate the clinical application of colostomy reduction combined with the placement of biological mesh to prevent stomal site incisional hernia.

Clinical data of patients who underwent colostomy reduction combined with biological mesh placement in the Department of Colorectal Surgery of Nanjing Drum Tower Hospital from January 2022 to December 2023 were analyzed. Surgical time, intraoperative blood loss, postoperative hospital stays, follow-up time, etc. were recorded. The incidence of stomal site incisional hernia (SSIH) was observed, along with postoperative incision infection, mesh infection, hematoma, seroma, intra-abdominal bleeding, intra-abdominal organ injury, congestion in the surgical area, foreign body sensation in the surgical area, pain in the surgical area, urinary retention, etc.

Eighteen patients were included, all of whom had the mesh placed in the preperitoneal space (Onlay technique). The surgeries were successful, with postoperative pain well-controlled (either by oral medication or by intravenous analgesia). Significant improvement was observed within 3 days. And by around 7 days, patients were mostly back to normal. None of the patients developed SSIH, incision infection, mesh infection, hematoma, intra-abdominal bleeding, intra-abdominal organ injury, congestion in the surgical area, foreign body sensation in the surgical area, or urinary retention. One patient experienced seroma, which improved after one week of local drainage tube placement. The tube was successfully removed and the patient was discharged, with subsequent good recovery.

Colostomy reduction combined with biological mesh placement is a safe and effective method for preventing SSIH. It can be considered for clinical application in similar patients.