经脐单孔与多孔法腹腔镜手术治疗贲门失弛缓症及食管裂孔疝的比较研究

目的 探讨经脐单孔腹腔镜手术治疗贲门失弛缓症及食管裂孔疝的安全性和可行性.方法 2008年1月至2011年12月,行腹腔镜手术治疗贲门失弛缓症及食管裂孔疝患者17例.其中,单孔法组7例,多孔法组10例.收集两组围手术期资料进行比较分析.结果 全部患者均顺利完成腹腔镜手术.单孔组手术时间115 ～ 180 min,出血量50～110ml,术后住院时间5～7d；多孔组手术时间100～ 155 min,出血量40～ 90 ml,住院时间5～9d.所有患者均无术后出血、食管漏、发热感染等并发症发生.单孔组患者术后脐部切口愈合良好,美容效果明显.结论 对于有经验的腹腔镜外科医师,单孔腹腔镜手术治疗贲门失弛缓症及食管裂孔疝是安全可行的,并具有极佳的美容效果.其临床应用价值仍需进一步研究证实.

Comparitive study of transumbilical single-incision versus conventional laparoscopic surgery in the treatment of achalaisa and hiatus hernia

Objective To study the clinical data of patients who underwent transumbilical single-incision and conventional laparoscopic fundoplication or hiatal hernia repair, explore the safety and feasibility of transumbilical single-incision laparoscopic surgery. Methods From Jan 2008 to Dec 2011, 17 patients underwent laparoscopic fundoplication or hiatal hernia repair in Shengjing Hospital of China Medical University. There were 7 patients in the single-incision group and 10 patients in the conventional group. Collect and compare the clinical data of the two groups. Results All the operations were successfully completed. The operation time, blood loss, postoperative hospital stay was 115 - 180 min,50 - 110 ml,5 - 7 days for single-incision group and 100 - 155 min,40 - 90 ml,5 - 9 days for conventional group. All the patients were free of postoperative bleeding, esophageal fistula and fever complications. The umbilical incision healled well with satisfactory cosmetic effect. Conclusions Transumbilical single-incision laparoscopic technique in the treatment of achalaisa and hiatus hernia is feasible for experienced laparoscope surgeon with reduced injury and excellent cosmetic effect. Its clinical application needs further study.