分析在腹膜前间隙放置补片修复并加强腹壁的同时联合Lap-re-Do Sugarbaker或Keyhole术式重建造口的可行性及治疗效果。

本研究采用回顾性描述性研究方法。回顾性分析2020年7月至2022年7月，四川大学华西医院采用Lap-re-Do Sugarbaker或Keyhole术式，行造口旁疝无张力修补术联合腹膜前间隙补片修复的8例患者的临床资料。纳入患者均合并腹腔污染、造口质量不佳、腹腔粘连等情况。对患者一般资料、手术情况、住院时长等进行分析，并随访记录患者术后并发症情况。

所有患者均顺利完成目标手术，手术时间162~620 min，平均为（454.63±113.38）min；中位疝囊大小（长×宽）为8.38（5.00，10.00）cm×7.63（4.00，8.50）cm；疝环直径7~15 cm，平均（9.50±2.88）cm；术后住院时长7~41 d，平均（18.25±9.06）d。术后随访2年，所有患者均未见造口旁疝复发。仅1例（1/8）患者因切口局部感染再次入院，经负压吸引、抗感染等对症治疗20 d后治愈出院。

制定严格纳入标准，对于接受造口旁疝无张力修补术合并腹腔污染、造口质量不佳、腹腔粘连等的高危人群，选择在腹膜前间隙放置补片安全且有效，在加强腹壁强度的同时可能会减少患者术后感染、腹腔粘连等并发症的发生。

To evaluate the feasibility and efficacy of preperitoneal mesh reinforcement combined with the Lap-re-Do Sugarbaker or Keyhole technique for parastomal hernia repair and stoma reconstruction.

This was a retrospective descriptive study. A retrospective analysis was conducted on the clinical data of 8 patients who underwent tension-free parastomal hernia repair with preperitoneal mesh placement and Lap-re-Do Sugarbaker/Keyhole at West China Hospital, Sichuan University between July 2020 and July 2022. All enrolled patients had concurrent conditions including intra-abdominal contamination, poor stoma construction, and intra-abdominal adhesions. Patient demographics, operative details, and length of hospital stay were analyzed, and postoperative complications were recorded during follow-up.

All patients successfully completed the planned procedure. Operative time ranged from 162 to 620 minutes, with a mean of (454.63±113.38) minutes; Median hernia sac size (length×width) was 8.38 (5.00, 10.00) cm×7.63 (4.00, 8.50) cm; Hernial ring diameter: 7-15 cm (mean 9.50±2.88 cm); Postoperative hospitalization: 7-41 days (mean 18.25±9.06 days). During the 2-year follow-up, no parastomal hernia recurrence was observed. One patient (1/8) required readmission for localized wound infection, which resolved after 20 days of negative-pressure wound therapy and anti-infection treatments.

With strict inclusion criteria, for high-risk patients undergoing tension-free parastomal hernia repair with concomitant abdominal cavity contamination, poor stoma quality, or intra-abdominal adhesions, mesh placement in the preperitoneal space is safe and effective. It can reinforce abdominal wall strength, and may potentially reduce the occurrence of postoperative complications such as infection and intra-abdominal adhesions.