Efficacy Analysis Of Laparoscopic Sugarbaker Repair Of Parastomal Hernia With Modified Hernia Sac Treatment

Background and ObjectiveParastomy hernia is one of the common complications after enterostomy,and operation is the only effective treatment.Parastomal hernia repair has various surgical methods,while patch repair is the main surgical method at present.With the popularization of laparoscopic technology,laparoscopic Sugarbaker mesh repair for parastomal hernia is widely used.The traditional laparoscopic Sugarbaker repair of the hernia sac is generally performed with the intermittent suture of the hernia ring with the preset crochet needle on the body surface,resulting in large suture tension and inaccurate closure of the hernia sac.In this study,the treatment of the hernia sac was modified during laparoscopic Sugarbaker repair,in which the hernia sac and hernia ring defects were completely closed by "three-dimensional" sutures using "fishbone thread".By comparing the clinical data of the modified surgical method and the traditional surgical method,the clinical efficacy of the two groups of cases was retrospectively analyzed to explore the safety and effectiveness of the modified laparoscopic parastomal hernia repair.MethodsA retrospective analysis was performed on the clinical data of patients with parastomal hernia who underwent laparoscopic Surgarbaker repair of parastomal hernia in the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021.A total of 67 patients were included in this study,and patients were divided into observation group and control group according to different treatment methods of the hernia sac.In the control group,32 patients were included in the traditional way to close the hernia ring defect with crochet stitch.The observation group was treated with modified hernia sac,i.e.,"three-dimensional" suture under endoscopy.A total of 35 cases were included.The intraoperative status(operation time,blood loss,intestinal injury),postoperative recovery status(first intestinal exhaust time,postoperative pain score and postoperative hospital stay),postoperative common complications and follow-up of the two groups were statistically analyzed.ResultsThere were no significant differences in age,gender,body mass index,diameter of hernia ring and associated underlying diseases between the two groups(P>0.05),and other research indicators were comparable.Comparison of intraoperative conditions:Intraoperative blood loss in the observation group and the control group were(18.1±6.6)mL and(16.1±6.1)mL,respectively,and the incidence of intraoperative intestinal injury was(5.7%)and(6.3%),respectively,with no statistical significance(P>0.05).The operation time of observation group(124.0±15.5)min was longer than that of control group(113.2±13.0)min,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the time of first ventilation and postoperative hospital stay between the two groups(P>0.05).There was no significant difference in postoperative infection,intestinal fistula and intestinal obstruction,and ostomy-related complications(ostomy prolapse,ostomy stenosis and ostomy ischemia)between the two groups(P>0.05).On the third day after surgery,the pain score in the observation group(2.8±1.0)was lower than that in the control group(3.6±1.0),the difference was statistically significant(P<0.05).The incidence of postoperative seroma in control group(15.6%)was higher than that in observation group(0),and the difference was statistically significant(P<0.05).The recurrence rate in the observation group(0%)was significantly lower than that in the control group(12.5%),and the difference was statistically significant(P=0.047).There was no significant difference in the incidence of chronic pain between the two groups(P>0.05).Conclusion1.Laparoscopic Sugarbaker repair of parastomal hernia with modified hernia sac treatment is a safe and effective procedure.During the operation,there was no increase in collateral injury,and early postoperative seroma and pain had more advantages.2.Laparoscopic Sugarbaker repair of parastomal hernia with modified hernia sac treatment is difficult to perform and requires close cooperation of the surgical team.3.Laparoscopic Sugarbaker repair of parastomal hernia with modified hernia sac treatment had a lower postoperative recurrence rate.