气腹与腹壁悬吊无气腹结合腹腔镜手术治疗滑动型食管裂孔疝17例疗效分析

目的评估气腹与腹壁悬吊无气腹结合腹腔镜食管裂孔疝修补和胃底折叠术治疗滑动型食管裂孔疝的临床价值。 方法回顾性分析2012年5月至2014年5月，北京同仁医院胸外科进行的17例气腹与腹壁悬吊无气腹结合腹腔镜食管裂孔疝修补和胃底折叠术的临床资料，其中采用Nissen术式15例，Toupet术式2例。 结果所有患者均顺利完成手术，无中转开腹，平均手术时间为45～220 min，术中出血量均小于50 ml，无术后并发症，全部治愈出院，术后平均住院时间10 d。随访时间1～24个月，16例患者临床症状完全消失，1例临床症状部分缓解，无明确复发病例。 结论气腹与腹壁悬吊无气腹结合腹腔镜滑动型食管裂孔疝修补和胃底折叠术是一种安全有效的外科治疗，具有广泛的推广价值。

Seventeen cases of analysis of efficacy for sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting

ObjectiveTo evaluate the clinical value of the method of surgical treatment in patients with sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting. MethodsThe clinical data of 17 cases of laparoscopic esophageal hiatal hernia repair combined with and gastric folding via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting was collected between May 2012 and May 2014, including 15 cases of Nissen operation and, 2 cases of Toupet operation. ResultsSurgeries in all patients were successfully completed, no transferring laparotomy, the average operation time was 45 to 220 minutes, intraoperative blood loss was less than 50 ml, there were no postoperative complications, all patients were cured and discharged, and the average hospitalization time was 10 days. Follow-up period was between 1 to 24 months. Clinical symptoms in 16 patients disappeared completely, and clinical symptoms in 1 case partly relieved, with no relapsed case. ConclusionSliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting is a safe and effective surgical treatment, and has wide value of popularization.