复合补片和生物补片治疗食管裂孔疝的疗效对比研究

目的:对比应用复合补片和生物补片治疗反流性食管炎和食管裂孔疝的疗效。方法:21例应用Crurasoft誖复合补片组及20例应用BiodesignTM Surgisis誖生物补片组修补食管裂孔疝病人,对比分析术后复发率和补片相关并发症发生的差异。结果:两组病人一般情况、食管裂孔长径和手术时间等方面无统计学差异。应用复合补片和生物补片均能使术前反流性食管炎的症状显著缓解。复合补片组和生物补片组围手术期并发症发生率分别为9.5%和30.0%,两组间无统计学差异。术后6个月随访裂孔疝复发率均为0。复合补片组和生物补片组长期随访平均时间分别为(16.3±8.9)个月和(17.3±6.8)个月,解剖性复发率分别为4.8%和5.0%,无统计学差异。两组病人均未发生食管侵蚀的并发症。复合补片组病人术后吞咽困难发生率高于生物补片组(38.1%比20..0%),但无统计学差异。结论:应用新一代小肠黏膜下基质补片和复合补片修补食管裂孔疝后疗效满意,复发率低,补片相关的严重并发症发生率差异无统计学意义。

Comparative study on efficacy of hiatal hernia mesh repair with composite mesh and biological mesh

Objective To compare the efficacy of hiatal hernia using biological mesh and composite mesh. Methods Post-operative recurrence rate and mesh-related complications was evaluated in 20 patients after hiatal hernia repair with BiodesignTM Surgisis and 21 patients with Crurasoft~. Results There was no difference between both groups with respect to baseline data, size of hiatal hernia and operation time. Significant improvement of symptoms was present in both groups. Peri-operative complications of composite mesh group and biological mesh group were 9.5% and 30.0% respectively without significant difference. No recurrence occurred on follow-up of six-month. Long-term follow-up of composite mesh group and biological mesh group was available at a mean of（16.3±8.9） months and （17.3±6.8） months respectively with the recurrence rates of 4.8% and 5.0%, P〉0.05. No esophageal erosion occurred in either group. The rate of dysphagia was higher in composite mesh group compared with that in biologic mesh group （38.1% vs. 20.0%）, but not reached significant level. Conclusions The new generation of small intestinal submucosa mesh and composite mesh have satisfying efficacy of hiatal hernia repair with lower recurrence rate and similar severe mesh-related complications.