腹腔镜补片修补巨大食管裂孔疝

目的探讨腹腔镜补片修补巨大食管裂孔疝的安全性和有效性。方法 2006年5月至2010年5月应用腹腔镜补片修补食管裂孔疝12例,采用全身麻醉,材料为聚丙烯和聚四氟乙烯补片,剪裁7.5cm×7.5cm大小圆形补片,用EMS固定于膈肌上。结果全部患者手术成功。术后1个月复查,症状按Visick评分：12例均为VisickⅠ。胃镜检查：食管下端糜烂减轻或消失。食管压力测定：（16.33±3.07）mmHg。24h食管内pH值〈4,总时间百分比均〈4%。钡餐检查：12例胸腔胃全部位于膈下腹腔内。12例患者随访1～5年,无胃烧灼感、反流症状,胃镜食管炎消失,钡餐食管裂孔疝无复发。5例贫血者,血色素升至正常。结论腹腔镜下补片修补食管裂孔疝安全、有效且复发率低。补片相关并发症需进一步随访观察。

Laparoscopic repair of large hiatal hernia with polypropylene and pelyterafluoroethlene

Objective To evaluate the safety and efficiency of laparoscopic repair of large hiatal hernia with polypropylene and pelyterafluoroethlene.Methods Under laparoscopy repaired large hiatal hernia with polypropylene and pelyterafluoroethlene for 12 patients from May 2006 to May 2010.Results Surgery of all patients were successful.After operation 1 month,the patients symptom according to Visick score：12 patients were Visick Ⅰ.Endoscopy：esophageal erosion reduce or disappear.Esophageal pressure measurement：（16.33 ± 3.07）mm Hg.24-hour esophageal within：pH 4 total time percentage 4 %.Barium checking：thoracic stomach were located within abdominal cavity.Twelve patients were followed up 1 to 5 years,no burning sensation in stomach,reflux,endoscopy esophagitis disappeared,barium hiatal hernia no reccurence,5 patients of anemia,hemolobin were rosed to normal.Conclusions Laparoscopic mesh repair large hiatal hernia is safe and effctive,and recurrence lower.Mesh-related complication will requir further follow-up.