Clinical effecacy exploratory of totally laparoscopic total extraperitoneal sublay repair of parastomal hernia

Objective:To investigate the initially clinical efficacy of totally laparoscopic total extra-peritoneal sublay repair of parastomal hernia.
Methods:The retrospective and descripitive study was conducted. The clinical data of one 74-year-old male patient with parastomal hernia after open radical operation for rectal cancer who was admitted to the Northeast International Hospital on October 2020 were collected. The patient underwent totally laparoscopic total extraperitoneal sublay repair of parastomal hernia. Observation indicators: (1) surgical and postoperative situations, including operation time, separation time of peritoneum, trocars use, volume of intraoperative blood loss, time to postoperative first flatus, discharge time and hospitalization costs; (2) follow-up, including time of follow-up, food intake, flatus and defecation, postoperative complications and hernia recurrence. Follow-up using outpatient examination was performed at postoperative 1 month to detect food intake, flatus and defecation, complications or hernia recurrence up to November 2020. Count data were represented as absolute numbers.
Results:(1) Surgical and postoperative situations: the patient successfully underwent totally laparoscopic total extraperitoneal sublay repair of parastomal hernia. The total operation time was 240 minutes, and the separation time of peritoneum was 115 minutes. There were only 3 trocars used and the volume of intraoperative blood loss was 20 mL. The patient had the first flatus at postoperative 12 hours, and the duration of postoperative hospital stay was 48 hours. The hospitalization cost was 21 148 yuan. (2) Follow-up: the patient was followed up for 1 month. During follow-up, the food intake, flatus and defecation were normal. The patient had no pain at stoma or puncture infection. No hernia recurrence was on the total abdominal CT.
Conclusion:The totally laparoscopic total extraperitoneal sublay repair of parastomal hernia is safe and fesible, with good short-term efficacy.