对比达芬奇机器人与腹腔镜在结肠造口旁疝Sugarbaker修补术的临床疗效，分析两种技术在该术式中效果差异与原因。

回顾性分析2023年2月至2025年2月在天津市人民医院疝和腹壁外科行造口旁疝Sugarbaker修补术的患者资料进行病例对照研究。共计纳入56例患者，依据手术方法的不同，分为机器人组15例，腹腔镜组41例。比较2组患者术前体重指数和疝环长径、手术时间、术中出血量、术后首日疼痛数字评定量表评分、术后恢复排气、排便时间、术后住院时间和住院总费用，随访观察造口旁疝复发和肠梗阻发生情况。

2组患者术前体重指数、疝环长径比较，差异无统计学意义。所有患者均按计划顺利完成手术，无中转开腹或改变术式，无手术相关严重并发症发生。与腹腔镜组相比，机器人组患者中位手术时间更长[M（IQR）][170（60）min比105（53）min]、中位住院总费用更高[70 562（3547）元比60 121（12 341）元]，但术后中位住院时间更短[4（1）d比5（2）d]、术后中位排便时间更短[3（2）d比4（1）d]、术后首日中位疼痛评分更低[2（1）分比5（2）分]，差异均有统计学意义（P<0.05）。术后随访1~24个月，中位随访时间12个月，2组患者造口旁疝复发率和肠梗阻发生率比较，差异均无统计学意义（P>0.05）。

两种造口旁疝Sugarbaker修补术均安全可行，达芬奇机器人在减轻术后疼痛、促进患者术后快速康复方面具有优势，腹腔镜在手术时间和住院总费用方面具有优势。

To compare the clinical efficacy of the Da Vinci robotic system and laparoscopic Sugarbaker repair for parastomal hernia, and to analyze the differences in effectiveness and underlying causes between the two surgical techniques.

A retrospective case-control study was conducted by analyzing the clinical data of patients who underwent Sugarbaker repair for parastomal hernia in the Department of Hernia and Abdominal Wall Surgery at Tianjin People’s Hospital between February 2023 and February 2025. A total of 56 patients were enrolled and divided into two groups according to the surgical approach: the robotic group (15 cases) and the laparoscopic group (41 cases). The two groups were compared in terms of preoperative body mass index (BMI), long diameter of the hernia ring, operative time, intraoperative blood loss, numerical rating scale (NRS) pain score on the first postoperative day, time to first flatus and defecation, postoperative hospital stay, and total hospitalization cost. Postoperative follow-up was performed to observe the recurrence of parastomal hernia and the occurrence of intestinal obstruction.

T There were no statistically significant differences between the two groups in preoperative BMI or hernia ring diameter. All operations were completed as planned without conversion to open surgery, change of surgical procedure, or occurrence of severe surgery-related complications. Compared with the laparoscopic group, the robotic group had a longer median operative time [M (IQR): 170 (60) min vs 105 (53) min] and higher median total hospitalization cost [70 562 (3 547) CNY vs 60 121 (12 341) CNY], but a shorter median postoperative hospital stay [4 (1) days vs 5 (2) days], shorter median time to defecation [3 (2) days vs 4 (1) days], and lower median NRS pain score on the first postoperative day [2 (1) points vs 5 (2) points]; all differences were statistically significant (P<0.05). The postoperative follow-up duration ranged from 1 to 24 months, with a median of 12 months. There were no significant differences between the two groups in the recurrence rate of parastomal hernia or the incidence of intestinal obstruction (P>0.05).

Both robotic and laparoscopic Sugarbaker repair for parastomal hernia are safe and feasible. The Da Vinci robotic approach offers advantages in reducing postoperative pain and facilitating rapid postoperative recovery, whereas laparoscopy demonstrates advantages in operative time and overall hospitalization cost.