腹腔鏡下修復後に再発した傍ストーマヘルニアに対して腹腔鏡下に修復しえた1例

A case of recurrent parastomal hernia after laparoscopic repair with successful laparoscopic surgery

◆要旨：腹腔鏡下に修復後に再発した傍ストーマヘルニアに対して腹腔鏡下に修復しえた1例を経験したので報告する．患者は74歳，女性．初回修復術後22か月頃に腹痛を訴え，CTで傍ストーマヘルニア再発と診断した．その後も症状が持続，増悪したため腹腔鏡下に再手術を施行した．術中所見では，メッシュと挙上腸管との間に径2cm大のヘルニア門を認めた．前回手術時のメッシュは剝がさずに，パリテックス^TMパラストーマルメッシュでヘルニア門を被い修復した．術後順調に経過し，8日目に退院した．術後21か月の時点で再発を認めていない．

We report a case of recurrent parastomal hernia after laparoscopic repair with successful laparoscopic surgery. The patient was a 74-year-old female who complained of abdominal pain around 22months after first-time parastomal hernia repair. CT imaging indicated a diagnosis of recurrent parastoma hernia. The pain continued and worsened after the diagnosis, so laparoscopic re-surgery was conducted. Intraoperatively, the hernia orifice measuring 2cm in diameter was found between mesh and the lateralised colon. Hernia space was repaired using a Parietex^TM Composite Parastomal mesh without tearing off the first mesh. Post operative course was uneventful, and the patient was discharged on the postoperative day 8. As of 21 months after surgery, no recurrence has been observed.