切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 369 -373. doi: 10.3877/cma.j.issn.1674-392X.2026.04.003

专家论坛

回肠代膀胱术后造口旁疝的治疗现状
李俊生1,2,(), 曹睿3, 邵翔宇1,2   
  1. 1210009 南京,东南大学附属中大医院普外科
    2210009 南京,东南大学附属中大医院疝外科
    3210009 南京,东南大学医学院
  • 收稿日期:2026-05-25 出版日期:2026-08-18
  • 通信作者: 李俊生
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金项目(320.6750.2022-07-01)

Current status of parastomal hernia treatment after ileal conduit diversion surgery

Junsheng Li1,2,(), Rui Cao3, Xiangyu Shao1,2   

  1. 1Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China;
    2Hernia Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China;
    3School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2026-05-25 Published:2026-08-18
  • Corresponding author: Junsheng Li
引用本文:

李俊生, 曹睿, 邵翔宇. 回肠代膀胱术后造口旁疝的治疗现状[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(04): 369-373.

Junsheng Li, Rui Cao, Xiangyu Shao. Current status of parastomal hernia treatment after ileal conduit diversion surgery[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(04): 369-373.

回肠代膀胱术是根治性膀胱切除术后患者常用的手术方式,其术后造口旁疝(ICPH)发生率较高。ICPH可能引起多种并发症。ICPH的治疗方法有腹腔镜修补术、开放修补术和造口移位等。本文就ICPH的发生率、并发症、治疗方法和效果,以及ICPH的预防和争议等方面进行阐述,并结合本团队在ICPH和结肠造口旁疝的临床经验,对ICPH治疗的主要事项和要点予以点评。

Ileal conduit diversion is a commonly performed surgical procedure following radical cystectomy, and the incidence of parastomal hernia after ileal conduit (ICPH) is notably high. ICPH may lead to a variety of complications. Treatment options for ICPH include laparoscopic repair, open repair, and stoma relocation, etc. This article reviews the incidence, complications, treatment modalities, and outcomes of ICPH, as well as the current controversies surrounding its prevention and management. Additionally, based on the author's clinical experience with ICPH and colostomy parastomal hernias, key considerations and technical points in the treatment of ICPH are summarized and commented upon.

图2 双侧输尿管造口术后右侧发生巨大输尿管造口旁疝
图3 采用腹腔镜Sugarbaker手术治疗回肠流出道造口旁疝术中所见造口缺损 3A修补前;3B修补后
图4 采用腹腔镜Sugarbaker手术治疗巨大输尿管造口旁疝 4A修补前;4B修补后注:箭头所示为输尿管。
[1]
张欣红, 马玉容, 邱志磊, 等. 膀胱癌泌尿造口患者社会疏离的潜在剖面分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(5): 639-644.
[2]
腾鹏, 田景昌, 鄂春翔, 等. 肌层浸润性膀胱癌患者根治性膀胱切除术预后列线图模型的构建及验证[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(5): 645-652.
[3]
Goffioul L, Bonnet P, Waltregny D, et al. Parastomal hernia after radical cystectomy with ileal conduit diversion: a narrative review[J]. Acta Chir Belg, 2021, 121(6): 373-379.
[4]
Narang SK, Alam NN, Campain NJ, et al. Parastomal hernia following cystectomy and ileal conduit urinary diversion: a systematic review[J]. Hernia, 2017, 21(2): 163-175.
[5]
Ghoreifi A, Allgood E, Whang G, et al. Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit[J]. BJU Int Sep, 2022, 130(3): 381-388.
[6]
Haque TF, Ghoreifi A, Moghaddam FS, et al. Perioperative and extended outcomes of patients undergoing parastomal hernia repair following cystectomy and ileal conduit[J]. World J Urol, 2024, 42(1): 482.
[7]
Mäkäräinen-Uhlbäck E, Vironen J, Falenius V, et al. Parastomal hernia: a Retrospective Nationwide Cohort Study comparing different techniques with long-term Follow-Up[J]. World J Surg, 2021, 45(6): 1742-1749.
[8]
Bel N, Blanc PY, Moszkowicz D, et al. Surgical management of parastomal hernia following radical cystectomy and ileal conduit: A French multi-institutional experience[J]. Langenbecks Arch Surg, 2023, 408(1): 344.
[9]
Helgstrand F, Rosenberg J, Kehlet H, et al. Risk of morbidity, mortality, and recurrence after parastomal hernia repair: a nationwide study[J]. Dis Colon Rectum, 2013, 56(11): 1265-1272.
[10]
Gillern S, Bleier JI. Parastomal hernia repair and reinforcement: the role of biologic and synthetic materials[J]. Clin Colon Rectal Surg, 2014, 27(4): 162-171.
[11]
Riansuwan W, Hull TL, Millan MM, et al. Surgery of recurrent parastomal hernia: direct repair or relocation?[J]. Colorectal Dis, 2010, 12(7): 681-686.
[12]
Donahue TF, Bochner BH. Parastomal hernias after radical cystectomy and ileal conduit diversion[J]. Investig Clin Urol, 2016, 57(4): 240-248.
[13]
Javaid A, Muhammad K, Qureshi N. Parastomal hernia repair: A 10-year retrospective study at District General Hospital—Recurrence and complications[J]. Int J Abdom Wall Hernia Surg, 2024, 7(2): 83-87.
[14]
Hopkins TB, Trento A. Parastomal ileal loop hernia repair with marlex mesh[J]. J Urol, 1982, 128(4): 811-812.
[15]
许熠, 邵翔宇, 李俊生. 膀胱切除术后造口旁疝的治疗[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(3): 262-265.
[16]
陈元浩, 刘敏, 陈杰, 等. 回肠代膀胱术后造口疝二种术式的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(2): 117-121.
[17]
Śmietański M, Szczepkowski M, Alexandre JA, et al. European Hernia Society classification of parastomal hernias[J]. Hernia, 2014, 18(1): 1-6.
[18]
Tully KH, Roghmann F, Pastor J, et al. Parastomal Hernia Repair With 3-D Mesh Implants After Radical Cystectomy and Ileal Conduit Urinary Diversion-A Single-center Experience Using a Purpose Made Alloplastic Mesh Implant[J]. Urology, 2019, 131: 245-249.
[19]
Sugarbaker PH. Peritoneal approach to prosthetic mesh repair of parasotomy hernias[J]. Ann Surg, 1985, 201(3): 344-346.
[20]
Berger D, Bientzle M. Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients[J]. Dis Colon Rectum, 2007, 50(10): 1668-1673.
[21]
Berger D, Bientzle M. Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair? A prospective, observational study with 344 patients[J]. Hernia, 2009, 13(2): 161-172.
[22]
Wada T, Kawada K, Hasegawa S, et al. Laparoscopic repair for recurrent parastomal hernia of an end stoma using the sandwich technique while preserving an ileal conduit: A case report[J]. Int J Surg Case Rep, 2016, 25: 75-78.
[23]
Fu X, Li M, Hua R, et al. Laparoscopic Sugarbaker repair of parastomal hernia following radical cystectomy and ileal conduit: a single-center experience[J]. BMC Surg, 2024, 24(1): 258.
[24]
Xu AJ, Shakir NA, Jun MS, et al. Robotic Assisted Repair of Post-Ileal Conduit Parastomal Hernia: Technique and Outcomes[J]. Urology, 2021, 158: 232-236.
[25]
Ayuso SA, Shao JM, Deerenberg EB, et al. Robotic Sugarbaker parastomal hernia repair: technique and outcomes[J]. Hernia, 2021, 25(3): 809-815.
[26]
Tobias-Machado M, Gomes DC, Faria EF, et al. Robotic parastomal hernia repair[J]. Int Braz J Urol, 2021, 47(2): 468-469.
[27]
Narang SK, Alam NN, Campain NJ, et al. Parastomal hernia following cystectomy and ileal conduit urinary diversion: a systematic review[J]. Hernia, 2017, 21(2): 163-175.
[28]
Dewulf M, Hildebrand ND, Bouwense SAW, et al. Parastomal hernias after cystectomy and ileal conduit urinary diversion: surgical treatment and the use of prophylactic mesh: a systematic review[J]. BMC Surg, 2022, 22(1): 118.
[29]
Suwa K, Ushigome T, Enomoto H, et al. Surgical Outcomes after Laparoscopic Repairs of Para-colostomy Hernia and Para-ileal-conduit Hernia: A Comparative Study[J]. J Anus Rectum Colon, 2024, 8(4): 340-347.
[30]
Liedberg F, Kollberg P, Allerbo M, et al. Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study[J]. Eur Urol, 2020, 78(5): 757-763.
[31]
Donahue TF, Bochner BH, Sfakianos JP, et al. Risk factors for the development of parastomal hernia after radical cystectomy[J]. J Urol, 2014, 191(6): 1708-1713.
[32]
Styrke J, Johansson M, Granåsen G, et al. Parastomal hernia after ileal conduit with a prophylactic mesh: a 10 year consecutive case series[J]. Scand J Urol, 2015, 49(4): 308-312.
[33]
Navratil P, Tranova MN, Izmaylov O, et al. Preventing parastomal hernia following radical cystectomy with ileal conduit diversion: outcomes of prophylactic mesh reinforcement[J]. Cent European J Urol, 2026, 79(2): 126-132.
[34]
Elhashamy H, Mohamed T, Irshid BAB, et al. Prevention of parastomal hernia after ileal conduit using prophylactic mesh: A meta-analysis of randomized controlled trials[J]. Arab J Urol, 2025, 24(1): 82-89.
[1] 王茹文, 潘辰, 车颖, 佟梦萦. 甲状腺热消融术后结节破裂三例病例报道及基于文献的系统分析[J/OL]. 中华医学超声杂志(电子版), 2026, 23(04): 316-323.
[2] 杨敏, 杜峻峰, 辛林璞. 腹腔镜胃癌根治术后常见并发症防治与管理[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(04): 352-355.
[3] 谢华林, 刘宾, 孙倩男, 王道荣. 改善术后肠造口功能研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(04): 398-401.
[4] 杨洋, 沈可欣, 费秉元, 王琪, 谢忠士. 腹腔镜疝修补术后补片感染合并肠瘘、膀胱瘘1例报告[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(04): 406-408.
[5] 杨永君, 王槐志. 腹腔镜胰十二指肠切除术主要并发症及处理[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(03): 215-218.
[6] 辛林璞, 杨敏, 杜峻峰. 腹腔镜结直肠癌根治术后常见并发症防治与管理[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(03): 248-251.
[7] 赵军抗, 张前进, 庄惠杰. 腹腔镜直肠癌根治术保留左结肠动脉的疗效及对预后的影响[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(03): 257-260.
[8] 马宁, 周太成, 陈双. 食管裂孔疝手术并发症的预防与处理:以单中心经验为核心的实践策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 253-258.
[9] 周哲琦, 艾克拜尔·艾力, 李义亮, 麦麦提艾力·麦麦提明, 玉素江·图荪托合提, 克力木·阿不都热依木. 机器人辅助与腹腔镜袖状胃切除联合胃底折叠及食管裂孔疝修补术的临床疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 259-264.
[10] 李赞林, 祖母乃提·玉山, 艾克拜尔·艾力, 克力木·阿不都热依木, 李义亮. 机器人3+1模式在食管裂孔疝修补术中的应用体会[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 272-276.
[11] 李文婷, 黄欢. 腹腔镜腹股沟疝修补术后血肿形成的危险因素及预防对策[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 296-300.
[12] 郑宇, 邱少凡, 宋春义, 张翔宇, 王佳, 马少卫. 不同腹腔镜手术对老年男性复发性腹股沟疝的效果研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 307-312.
[13] 陈康, 王光远, 苟天相, 刘勇, 瞿涛. 生物补片在腹腔镜经腹腹膜前疝修补手术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(03): 313-317.
[14] 张宇, 郑卫华, 张俊晶. 门静脉高压症的诊治及并发症研究现状与展望[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(04): 537-544.
[15] 方荣焕, 孟子凡, 李馥彤, 鹿云皓, 杨永生. 肝硬化门静脉高压症脾切除术后并发症研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(04): 642-647.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?