gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2023-22-2-141-148gnck-1751Research ArticleОБЗОРЫ ЛИТЕРАТУРЫ И МЕТААНАЛИЗLITERATURE REVIEWS AND METAANALYSISПарастомальные грыжи: актуальное состояние проблемы (обзор литературы)Parastomal hernias: the current state (review)https://orcid.org/0000-0003-4276-6007КоптеевН. Р.KopteevN. R.

Коптеев Никита Романович — аспирант СПБГУ, врач-хирург 1 хирургического отделения

пр. Культуры, д. 4, г. Санкт-Петербург, 194291, Россия

Университетская наб., д. 7-9, г. Санкт-Петербург, 199034, Россия

Nikita R. Kopteev — post-graduate student of St. Petersburg State University, surgeon of the 1st surgical department

Kultury Ave., 4, St. Petersburg, 194291, Russia

Universitetskaya nab., 7-9, St. Petersburg, 199034, Russia

nikitakopteyev@mail.ruhttps://orcid.org/0000-0002-4961-7381ОвчинниковТ. С.OvchinnikovT. S.

Овчинников Тимофей Сергеевич — ординатор

Пискаревский пр., д. 47, г. Санкт-Петербург, 195067, Россия

Timofey S. Ovchinnikov — Resident of the Department of Hospital Surgery named after V.A. Oppel

Piskarevsky Ave., 47, St. Petersburg, 195067, Russia

https://orcid.org/0000-0002-5535-6915ЛодыгинА. В.LodyginA. V.

Лодыгин Александр Владимирович — к.м.н., доцент кафедры факультетской хирургии СПБГУ, заведующий 1 хирургического отделения

пр. Культуры, д. 4, г. Санкт-Петербург, 194291, Россия

Университетская наб., д. 7-9, г. Санкт-Петербург, 199034, Россия

Alexander V. Lodygin — Candidate of Medical Sciences, Associate Professor of the Department of Faculty Surgery

Kultury Ave., 4, St. Petersburg, 194291, Russia

Universitetskaya nab., 7-9, St. Petersburg, 199034, Russia

БогатиковА. А.BogatikovA. A.

Богатиков Александр Александрович — к.м.н., заместитель главного врача по хирургической помощи

пр. Культуры, д. 4, г. Санкт-Петербург, 194291, Россия

Alexander A. Bogatikov — Candidate of Medical Sciences, Deputy Chief Physician for Surgical Assistance

Kultury Ave., 4, St. Petersburg, 194291, Russia

https://orcid.org/0000-0002-4958-5850КащенкоВ. А.KashchenkoV. A.

Кащенко Виктор Анатольевич — профессор, д.м.н., заместитель генерального директора по научной работе

пр. Культуры, д. 4, г. Санкт-Петербург, 194291, Россия

Университетская наб., д. 7-9, г. Санкт-Петербург, 199034, Россия

Viktor A. Kashchenko — Professor, Doctor of Medical Sciences, Deputy General Director for Research

Kultury Ave., 4, St. Petersburg, 194291, Russia

Universitetskaya nab., 7-9, St. Petersburg, 199034, Russia

ФГБУ СЗОНКЦ им. Л.Г. Соколова ФМБА России; ФГБОУ Санкт-Петербургский государственный университетРоссияNorth-Western Regional Scientific and Clinical Center; St.Petersburg State UniversityRussian FederationФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова», кафедра госпитальной хирургии имени В.А. ОппеляРоссияNorth-Western State Medical University named after I.I. Mechnikov”, Department of Hospital Surgery named after V.A. OppelRussian FederationФГБУ СЗОНКЦ им. Л.Г. Соколова ФМБА РоссииРоссияNorth-Western Regional Scientific and Clinical CenterRussian Federation202321062023222141148Copyright © Коптеев Н.Р., Овчинников Т.С., Лодыгин А.В., Богатиков А.А., Кащенко В.А., 20232023Коптеев Н.Р., Овчинников Т.С., Лодыгин А.В., Богатиков А.А., Кащенко В.А.Kopteev N.R., Ovchinnikov T.S., Lodygin A.V., Bogatikov A.A., Kashchenko V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1751

Ежегодно наблюдается рост количества пациентов с кишечными стомами, что приводит к увеличению числа случаев возникновения парастомальных грыж (ПСГ). Более чем у 50% стомированных пациентов, спустя два года и более, после радикальной операции, возникает парастомальная грыжа. На сегодняшний день существует множество хирургических методов лечения ПСГ, однако так и не принят единый алгоритм выбора оперативной методики.

Целью данного обзора является изучение современных хирургических методов лечения парастомальных грыж и их отдаленных результатов, определение оптимального доступа и оперативного пособия.

Проведенный обзор литературы показал, что во всех случаях хирургического лечения ПСГ необходимо использовать сетчатые импланты. Оптимальной методикой герниопластики ПСГ является лапароскопический вариант Sugarbaker в связи с низким риском развития рецидива и технической простотой выполнения. В случае наличия у пациентов больших, гигантских ПСГ или при рецидиве методикой выбора является операция STORRM, классическая транспозиция стомы не используется ввиду высокого риска рецидива. Применение герниопластики Pauli/ePauli у пациентов с ПСГ демонстрирует низкий показатель рецидивов в краткосрочном периоде, однако на данный момент отсутствуют отдаленные результаты у этой категории пациентов.

Every year there is an increase in the number of patients with intestinal stoma, which leads to an increase in the incidence of parastomal hernias (PSH). More than 50% of ostomy patients develop a parastomal hernia two or more years after radical surgery. To date, there are many surgical options for PSH, however, a unified algorithm for choosing an operational technique has not been evolved.

The purpose of this review is to study modern surgical methods for the treatment of PSH and their late results, to determine the optimal approach and benefits.

The review of the literature showed that in all cases of surgical treatment of PSH it is necessary to use mesh implants. The optimal technique for PSH hernioplasty is the laparoscopic version of Sugarbaker due to the low risk of recurrence and technical simplicity. In patients with large and giant PSH or hernia recurrence, STORRM is the technique of choice; classical stoma transposition is not used due to the high risk of recurrence. The use of Pauli/ePauli technique demonstrates a low recurrence rate, but there are no late results in this category of patients.

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The authors declare that there are no conflicts of interest present.