腹腔镜食管裂孔疝修补术的初步探讨

目的探讨腹腔镜食管裂孔疝修补和胃底折叠术（Toupet手术）治疗食管裂孔疝的临床效果。方法 2009年1月～2010年5月,21例患者行腹腔镜食管裂孔疝（Ⅰ型9例,Ⅱ型4例,Ⅲ型6例,Ⅳ型2例）修补,采用单纯缝合膈肌脚,补片完全缝合,补片缝合加钉合等方法修补食管裂孔疝,并同期行部分胃底折叠术。结果本组患者手术均获成功,手术时间85～170min。无中转开腹及死亡病例。术后平均住院7d。术后随访1～16个月,20例临床症状完全消失,1例改善不明显,无明确复发病例。结论腹腔镜食管裂孔疝修补和胃底折叠术安全有效,应根据患者情况采用个体化的修补方式。

Clinical evaluation of laparoscopic esophageal hiatal hernia repair.

Objective To explore the clinical effects of laparoscopic repair of esophageal hiatal hernia with Toupet partial fundoplication.Methods From January 2009 to May 2010,twenty-one patients with esophageal hiatal hernia （typeⅠin 9,typeⅡin 4,type Ⅲ in 6 and type Ⅳ in 2） were performed by laparoscopy in our hospital.Results The operation was performed successfully in all cases.The operation time was range from 85 to 170min and the mean postoperative hospital stay was 7 days.There was no conversion and death.The patients were followed up for 1 to 16 month.The symptoms of twenty patients disappeared,there was no hernia recurrence.Conclusions Laparoscopic repair of esophageal hiatal hernia with Toupet partial fundoplication is secure and effective,it should be performed individually.