A Report Of 65 Cases Underwent Lap-re-Do Keyhole Technique For Parastomal Hernia And Relevant Literature Review

Background:Parastomal hernia is one of common tardive complication after many neostomy,and in fact,it is a part of ventral hernia.Morbidity of parastomal hernia is different and extreme variation between each reports.This difference is related to lacking uniform definition and diagnostic criteria,also follow-up visit period.Parastomal hernia can not be self-healing and the hernia block will increase in size with development of the history course.Sutures plastic operation of parastomal hernia is very different from others AEH(abdominal external hernia),because of exsiting of stoma,which makes parastomal hernia having particularity.Laparoscopic hernioplasty for parastomal hernia is developed and improved,now there are three surgical Laparoscopic hernioplasty methods that are reported frequently:Keyhole method?Sugarbaker method and Sandwich method,they have respective feature.On the whole,it is very troublesome to deal with parastomal hernia for surgical clinical work,surgeon hold prudent attitude to surgical operation of parastomal hernia,and there are also not a standard surgical method to treat parastomal hernia.Objective:By analyzing the clinical datum and follow-up visit data about 65 cases underwent Lap-re-Do Keyhole technique for parastomal hernia and reviewing relevant literaturs,to summarize the pathogenesisan and prophylaxis of parastomal hernia,also,The clinical data of further to explore the safety and feasibility of Lap-re-Do Keyhole technique for parastomal hernia,so as to provide clinical experience to make a diagnosis and give treatment to parastomal hernia.Methods:The clinical data of sixty-five cases underwent Lap-re-Do Keyhole technique for parastomal hernia were analyzed retrospectively,which covering the cases from november 2011 to December in QiLu Hospital general surgery department.Collect and analyse the datum about mean OR Time(minutes)?mean POS(days)?time to mobilization(hours)?seroma?Ileus?intestinal perforation?chronic pain?recurrences and colostomy stenosis.Results:we conduct Lap-re-Do Keyhole technique successfully for 65 cases,mean OR Time(minutes)±SD is 147±57.32;mean POS(days)±SD is 7.2±1.61;time to mobilization(hours)±SD is 63± 16.12;we found 2 cases of 65 cases were complicated by seroma,3 cases were complicated by ileus,1 were complicated by intestinal perforation.we follow-up visit 65 cases and obtain relevant clinical data,we found that 1 cases of 65 cases appeared recurrences?1 cases appeared colostomy stenosis,1 cases appeared chronic pain one month after operation.Conclusions:Lap-re-Do Keyhole technique is an comprehensiveness surgical method which associating mesh hepatorrhaphy with colostomy reconstruction.It consider function and appearance of colostomy while repairing.we think it has satisfying clinical effects in terms of treating parastomal hernia by analyzing data of operation and follow-up observation.It is safe and feasible clinically with low recurrence rate.Therefore,it deserve our learning and use for reference.