腹腔镜食道裂孔疝修补术的临床效果分析：附51例报告

目的:探讨腹腔镜食道裂孔疝修补术的安全性和疗效。方法:回顾分析2012年7月—2016年7月51例行腹腔镜食道裂孔疝修补术的患者临床资料。结果:51例患者均顺利接受腹腔镜食道裂孔疝修补术。术中裂孔缝合修补后均采用补片加强固定。对无明显禁忌证患者,同时行Dor胃底折叠术。平均时间(100±15.4)min,术中出血量平均(28±15.4)mL,术后平均住院时间2d。术后胸痛、进食后哽噎等疝囊压迫症状明显缓解,反酸,烧心等反流症状也得到明显改善。无严重并发症发生,均在4周内恢复正常饮食。平均随访32个月,未见裂孔疝复发及补片相关并发症。结论:腹腔镜食道裂孔疝修补术是安全有效的手术方式,食道裂孔缝合关闭后使用补片加强修补可以降低裂孔疝的复发率。

Clinical efficacy of laparoscopic hiatal herniorrhaphy: a report of 51 cases

Objective: To examine the safety and efficacy of laparoscopic hiatal hernia repair. Methods: The clinical data of 51 patients undergoing laparoscopic hiatal hernia repair from July 2012 to July 2016 were retrospectively analyzed. Results: In all the 51 patients, laparoscopic hiatal herniorrhaphy was uneventfully performed, and a mesh was used to reinforce hiatal closure during operation. Dor fundoplication was performed at the same time in those without obvious contraindications. The average operative time was (100±19.6) min, the average blood loss was (28±15.4) mL, and the average length of hospital stay was 2 d. The symptoms caused by compression of the hernia sac contents such as chest pain and choke after eating were significantly alleviated, and the reflux-related symptoms such as acid regurgitation and heartburn were significantly improved after operation. No serious complications occurred, and all patients returned to normal diet within four weeks after operation. Follow-up was conducted for an average of 32 months, and no recurrence or mesh-related complications were noted. Conclusion: Laparoscopic hiatal hernia repair is a safe and effective procedure, and mesh reinforcement after hiatal closure can reduce the recurrence of hiatal hernia.