完全腹腔镜下食管裂孔疝修补联合抗反流术58例临床分析  

Completely laparoscopic hiatal hernia repair with antireflux surgery:A clinical analysis of 58 patients

作　　者：孙作成[1,2] 高红雷[1,2] 徐文广[1,2] 许加友[1,2] 

机构地区：[1]潍坊市人民医院普通外科 [2]潍坊医学院,山东潍坊261041

出　　处：《中国实用外科杂志》2013年第5期386-387,392,共3页Chinese Journal of Practical Surgery

摘　　要：目的观察完全腹腔镜下食管裂孔疝修补联合抗反流术治疗食管裂孔疝的临床价值。方法总结潍坊市人民医院自2008年5月至2012年8月间收治的58例食管裂孔疝病人(Ⅰ型26例,Ⅱ型8例,Ⅲ型20例,Ⅳ型4例)行完全腹腔镜下食管裂孔疝修补联合抗反流术治疗的临床资料。结果 58例手术顺利完成,无中转开腹病例,手术时间1.5～3.0h,术中出血量50～150mL,其中32例采用不可吸收线缝合修补疝缺口,26例应用补片修补疝缺口。58例行胃底270部分折叠术(Toupet术)。肠道功能恢复时间24～48h,进食时间36～72h,术后住院时间4～6d。随访时间1～50个月,42例病人临床症状完全消失,16例临床症状部分缓解,无明确复发病例。结论完全腹腔镜下食管裂孔疝修补联合抗反流术是根据病人情况采用个体化的修补方式,是一种微创、安全、有效的外科治疗。Objective To evaluate the clinical value of completely laparoscopic hiatal hernia repair with antireflux surgery. Methods The clinical data of 58 patients （type Ⅰ in 26, type Ⅱ in 8, type Ⅲ in 20, type IV in 4） performed completely laparoseopic hiatal hernia repair and Toupet fundoplication from May 2008 to August 2012 in Weifang People ＇ s Hospital were analyzed. Results All of the operation were successful within 1.5-3.0 h. Blood loss during operation procedure was 50-150 mL. Among 58 patients, nonabsorbable suture was used in 32 patients and mesh was used in 26 patients. Recovery time of intestinal tract function was 24-48 h. The time of taking liquid food was 36-72 h. The time in hospital was 5-8 d. The patients were followed up for 1 to 50 months. The symptoms of 42 patients disappeared and 16 patients were partial remission. There was no hernia recurrence. Conclusion Completely laparoseopic hiatal hernia repair with antireflux surgery according to the eonditions of patients is a minimally invasive, safe and effective surgery with a good prospect.

关 键 词：腹腔镜 食管裂孔疝 补片 抗反流术 胃底折叠术 

分 类 号：R6[医药卫生—外科学]