论文部分内容阅读
目的:探讨全腹腔镜完全腹膜外造口旁疝修补术的初步临床疗效。方法:采用回顾性描述性研究方法。收集2020年10月东北国际医院收治的1例74岁男性开腹直肠癌术后造口旁疝患者的临床资料。患者行全腹腔镜完全腹膜外造口旁疝修补术。观察指标：(1)手术及术后情况包括手术时间、腹膜分离时间、穿刺套管使用情况、术中出血量、术后首次肛门排气时间、术后出院时间、住院费用。(2)随访情况：随访时间、患者进食及肛门排气排便情况、术后并发症发生情况、疝复发情况。随访时间截至2020年11月。计数资料以绝对数表示。结果:(1)手术及术后情况：患者成功行全腹腔镜完全腹膜外造口旁疝修补术。手术时间为240 min，腹膜分离时间为115 min，术中使用3个穿刺套管，术中出血量为20 mL，术后首次肛门排气时间为12 h，术后48 h出院，住院费用为21 148元。(2)随访情况：患者完成术后1个月随访，进食及肛门排气排便正常，造瘘口处无疼痛，套管口无感染。复查全腹部CT未见疝复发。结论:全腹腔镜完全腹膜外造口旁疝修补术安全、有效，短期疗效良好。“,”Objective:To investigate the initially clinical efficacy of totally laparoscopic total extra-peritoneal sublay repair of parastomal hernia.Methods:The retrospective and descripitive study was conducted. The clinical data of one 74-year-old male patient with parastomal hernia after open radical operation for rectal cancer who was admitted to the Northeast International Hospital on October 2020 were collected. The patient underwent totally laparoscopic total extraperitoneal sublay repair of parastomal hernia. Observation indicators: (1) surgical and postoperative situations, including operation time, separation time of peritoneum, trocars use, volume of intraoperative blood loss, time to postoperative first flatus, discharge time and hospitalization costs; (2) follow-up, including time of follow-up, food intake, flatus and defecation, postoperative complications and hernia recurrence. Follow-up using outpatient examination was performed at postoperative 1 month to detect food intake, flatus and defecation, complications or hernia recurrence up to November 2020. Count data were represented as absolute numbers.Results:(1) Surgical and postoperative situations: the patient successfully underwent totally laparoscopic total extraperitoneal sublay repair of parastomal hernia. The total operation time was 240 minutes, and the separation time of peritoneum was 115 minutes. There were only 3 trocars used and the volume of intraoperative blood loss was 20 mL. The patient had the first flatus at postoperative 12 hours, and the duration of postoperative hospital stay was 48 hours. The hospitalization cost was 21 148 yuan. (2) Follow-up: the patient was followed up for 1 month. During follow-up, the food intake, flatus and defecation were normal. The patient had no pain at stoma or puncture infection. No hernia recurrence was on the total abdominal CT.Conclusion:The totally laparoscopic total extraperitoneal sublay repair of parastomal hernia is safe and fesible, with good short-term efficacy.