傍ストーマヘルニアと腹壁瘢痕ヘルニアの合併に対し腹腔鏡下Sugarbaker法を施行した1例

A case of a parastomal hernia associated with an abdominal incisional hernia repaired using the laparoscopic Sugarbaker technique

◆要旨：患者は82歳，女性．80歳時に腹会陰式直腸切断術を受け，S状結腸人工肛門を造設された．人工肛門周囲の膨隆を主訴に来院し，腹部CTで傍ストーマヘルニアと腹部正中切開創部の腹壁瘢痕ヘルニアと診断された．後日入院し手術を行った．腹腔鏡下Sugarbaker法を施行し，両ヘルニアに対してパリテックス^TMパラストーマルメッシュ1枚を用いて同時に修復した．術後腸麻痺を合併したが改善し13日目に退院した．術後14か月経過したが再発を認めていない．

An 82-year-old woman who had undergone abdominoperineal resection for rectal cancer and sigmoid colostomy two years previously visited our hospital with a complaint of a bulge around the stoma. Computed tomography scan indicated a diagnosis of parastomal hernia associated with an abdominal incisional hernia. She was admitted and underwent an operation. The laparoscopic Sugarbaker technique was performed using a Parietex^TM Composite Parastomal mesh to repair both hernias simultaneously. Although temporary intestinal paresis developed, the patient was discharged 13 days after the operation. She remained asymptomatic at 14 months after the operation.