腹腔镜手术治疗食管裂孔疝的42体会

目的探讨使用腹腔镜行食管裂孔疝修补术的疗效和安全性。方法对42例食管裂孔疝患者行腹腔镜食管裂孔疝修补术,其中32例行胃底360°折叠术(Nissen术),10例行胃底270°部分折叠术(Toupet术)。39例采用4号丝线缝合修补疝缺口,3例应用补片修补疝缺口。结果42例腹腔镜食管裂孔疝修补术全部成功。手术时间平均(138±22)min,失血平均(62±16)ml;无术后并发症;术后平均住院(5.2±1.9)d。术后症状完全消失32例(76%),好转10例(24%)。结论腹腔镜食管裂孔疝修补术具有疗效确定、安全和创伤小的优点,值得进一步推广应用。

The experience of laparoscopic surgery of esophageal hiatal hernia(a report of 42 cases)

Objective To investigate the efficacy and safety of laparoscopic srugery of esophageal hiatal hernia.Methods 42 patients with hiatal hernia underwent laparoscopic hiatal hernia repair,including 32 cases of Nissen operation,10 cases of Toupet operation.39 cases of hernia repaired with suture,3 cases repaired with Bard CruraSoft Mesh.Results 42 cases of laparoscopic hiatal hernia repair was successful in all.The average operation time was 138±22 min and the mean blood loss was 62±16 ml,no postoperative complications.Mean postoperative hospital stay was 5.2±1.9 days.Symptoms completely disappeared in 32 cases（76%）,improved in 10 cases（24%）.Conclusions Laparoscopic repair of esophageal hiatal hernia with efficacy,safety and the advantages of minimally invasive,should be further popularized.