Lap-re-Do Keyhole versus Lap-re-Do Sugarbaker techniques in large parastomal hernia repair: a retrospective cohort study.

IF 2.6 2区医学 Q1 SURGERY Hernia Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI:10.1007/s10029-024-03130-9

Xiaojian Fu, Minglei Li, Rong Hua, Qiyuan Yao

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Abstract

Purpose: To review the safety and efficacy of Lap-re-Do technique in the treatment of large parastomal hernia.

Methods: We retrospectively analyzed the recurrence and complications of 81 patients with large parastomal hernia who underwent Lap-re-Do technique in Huashan Hospital of Fudan University from May 2010 to December 2019. And the patients should be able to complete follow-up. With such criteria, we included 40 Lap-re-Do Keyhole patients and 41 Lap-re-Do Sugarbaker patients. Observation time was defined as time to recurrence, death, or last nonevent visit.

Results: In large parastomal hernias, Lap-re-Do had a recurrence rate of 25.9% and complication rate of 16.0%, and reoperation rate of 9.9% during the average follow-up time of 41.1 ± 17.8 months. Recurrence rates were 40% (16/40) after Lap-re-Do Keyhole repair and 12.2% (5/41) after Lap-re-Do Sugarbaker repair. Complication rates were 12.5% after Lap-re-Do keyhole and 19.5% after Lap-re-Do Sugarbaker repair Re-operation rates referred to Lap-re-Do keyhole repair were 15% and Lap-re-Do Sugarbaker repair 4.9% during follow-up.The majority of reoperations were indicated by recurrence.

Conclusions: Large parastomal hernias are still difficult to be treated. Lap-re-Do Sugarbaker is recommended as an appropriate procedure to close the hernia ring, removing the lengthy colostomy, and effectively reduce recurrence and complication rates.

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腹腔再造锁孔技术与腹腔再造苏加贝克技术在大型腹股沟旁疝修补术中的应用：一项回顾性队列研究。

目的：回顾性分析腹腔镜腹股沟旁巨大疝治疗的安全性和有效性：方法：回顾性分析2010年5月-2019年12月期间在复旦大学附属华山医院接受Lap-re-Do技术治疗的81例大孔旁疝患者的复发率和并发症情况。并且患者应能完成随访。根据这些标准，我们纳入了40例Lap-re-Do Keyhole患者和41例Lap-re-Do Sugarbaker患者。观察时间定义为复发、死亡或最后一次非事件就诊的时间：在平均 41.1 ± 17.8 个月的随访时间内，Lap-re-Do 法治疗大孔旁疝的复发率为 25.9%，并发症发生率为 16.0%，再次手术率为 9.9%。腹腔镜锁孔修补术后的复发率为40%（16/40），腹腔镜苏加贝克修补术后的复发率为12.2%（5/41）。随访期间，Lap-re-Do锁孔修复术后的并发症发生率为12.5%，Lap-re-Do Sugarbaker修复术后的并发症发生率为19.5%，Lap-re-Do锁孔修复术后的再次手术率为15%，Lap-re-Do Sugarbaker修复术后的再次手术率为4.9%：结论：巨大的吻合口旁疝仍然难以治疗。结论：大型吻合器旁疝仍然是治疗的难点，建议采用 Lap-re-Do Sugarbaker 修补术关闭疝环，去除冗长的结肠造口，并有效降低复发率和并发症发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.