| 腹腔镜手术治疗小儿食管裂孔疝的效果分析 |
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| 引用本文： | 庄著伦,莫绪明,孙剑,彭卫,戚继荣,张玉喜,武开宏,钱波,郁迪,杨玉忠,陈涌. 腹腔镜手术治疗小儿食管裂孔疝的效果分析[J]. 中华解剖与临床杂志, 2021, 26(4): 460-464. DOI: 10.3760/cma.j.cn101202-20200405-00115 |
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| 作者姓名： | 庄著伦 莫绪明 孙剑 彭卫 戚继荣 张玉喜 武开宏 钱波 郁迪 杨玉忠 陈涌 |
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| 作者单位： | 南京医科大学附属儿童医院小儿胸心外科，南京 210008 |
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| 摘 要： | 目的:探讨腔镜下食管裂孔疝修补+Nissen胃底折叠术治疗小儿食管裂孔疝的可行性及临床疗效。方法:回顾性分析2007年3月—2020年3月南京医科大学附属儿童医院小儿胸心外科收治的57例食管裂孔疝患儿的临床资料，其中男35例、女22例，年龄为2～97(17±4.17)个月。依据解剖分型标准，Ⅰ型46例，Ⅱ型7例，Ⅲ型4...
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| 关 键 词： | 疝，食管裂孔 腹腔镜外科手术 食管裂孔疝修补术 胃底折叠术 儿童 |
| 收稿时间： | 2020-04-05 |
Analysis of the effect of laparoscopic surgery on children with hiatal esophageal hernia |
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| Zhuang Zhulun,Mo Xuming,Sun Jian,Peng Wei,Qi Jirong,Zhang Yuxi,Wu Kaihong,Qian Bo,Yu Di,Yang Yuzhong,Chen Yong. Analysis of the effect of laparoscopic surgery on children with hiatal esophageal hernia[J]. Chinese Journal of Anatomy and Clinics, 2021, 26(4): 460-464. DOI: 10.3760/cma.j.cn101202-20200405-00115 |
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| Authors: | Zhuang Zhulun Mo Xuming Sun Jian Peng Wei Qi Jirong Zhang Yuxi Wu Kaihong Qian Bo Yu Di Yang Yuzhong Chen Yong |
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| Affiliation: | Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing 210008, China |
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| Abstract: | Objective To explore the feasibility, safety, surgical method, and therapeutic effect of the laparoscopic treatment of esophageal hiatal hernia in children.Methods Clinical data of 57 children with esophageal hiatal hernia in the Department of Pediatric Thoracic Surgery, Children's Hospital of Nanjing Medical University from March 2007 to March 2020 were retrospectively analyzed, including 35 males and 22 females, aged 2-97 (17±4.17) months. The anatomical classification was as follows: Type I 46 cases, TypeⅡ 7 cases, and Type Ⅲ 4 cases. All the children underwent upper gastrointestinal angiography to confirm the diagnosis further. One case was converted to laparotomy during operation, and other children completed the operation under laparoscopy and Nissen fundoplication. Operative time, intraoperative blood loss, and length of hospital stay were recorded, and the recovery of clinical symptoms including dysphagia, vomiting, acid reflux, abdominal distension, hematochezia, incision infection, and postoperative recurrence was observed.Results A total of 57 children completed the operation under laparoscopy and Nissen fundoplication, and one case was converted to laparotomy. The operative time was 93-176 (129±33.6) min, hospital stay was 9-14 (11±2.3) days, and mean blood loss was 8-15 mL. Two cases of severe abdominal distension were cured by conservative treatment after operation. One case of recurrence was treated by laparoscopic surgery. Gastrointestinal and respiratory symptoms were substantially improved postoperatively. Incision infection, dysphagia, and esophageal reflux were not observed. The follow-up period was from January to 8 years, and the follow-up average was 17 months. All the others remained symptom-free and well developed, and body weight increased.Conclusions The treatment of laparoscopic and Nissen fundoplication for hiatal hernia has the advantages of less trauma, definite curative effect, clear surgical vision, short operation time, quick postoperative recovery, and low postoperative complications. Total laparoscopic surgery for hiatal hernia is a safe, reliable, and effective minimally invasive surgery method. |
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| Keywords: | Hernia hiatal Laparoscopic surgery procedures Hiatal hernia repair Fundoplication Child |
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