腹腔镜Ⅲ、Ⅳ型食管裂孔疝修补术54例临床分析  

Clinical analysis of laparoscopic typeⅢ、Ⅳhiatal hernia repair

作　　者：邵翔宇[1] 程韬 嵇振岭[1] 李俊生[1] SHAO Xiang-yu;CHENG Tao;JI Zhen-ling;LI Jun-sheng(Department of General Surgery,Affiliated Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院普外科,江苏南京210009

出　　处：《中国实用外科杂志》2021年第4期409-411,414,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金青年基金(No.81600407)。

摘　　要：目的分析腹腔镜手术治疗Ⅲ、Ⅳ型食管裂孔疝的方法和疗效。方法回顾性分析2014年1月至2021年1月东南大学附属中大医院普外科收治的54例行腹腔镜手术治疗的Ⅲ、Ⅳ型食管裂孔疝病人的临床资料,手术方式为食管裂孔疝修补术+胃底折叠术。随访观察术后疗效及并发症发生情况。结果Ⅲ、Ⅳ型食管裂孔疝54例,包括Ⅲ型食管裂孔疝33例,Ⅳ型21例。手术时间为(166.1±67.2)min,术后中位住院时间为7(4~42)d。无围手术期死亡,中转开放手术2例。所有病人术后症状明显改善。随访46(8~80)个月,无疝复发。结论对于Ⅲ型和Ⅳ型食管裂孔疝病人,建议早期行腹腔镜食管裂孔疝修补术及胃底折叠术治疗,以减少并发症发生。Objective To analyze the outcomes of laparoscopic treatment of the largest hiatal hernias of type Ⅲ and Ⅳ hiatal hernias.Methods A total of 54 patients diagnosed with type Ⅲ and Ⅳ hiatal hernia were included,and repaired with laparoscopic procedure.Results 54 cases,including 33cases of type Ⅲ and 21 cases of type Ⅳ hiatal hernias successfully repaired with the laparoscopic procedure.The mean operation time was166.1±67.2min,and the medium postoperative hospital stay was 7d(4-42).There was no perioperative death.Two patient needed conversion,and all the others were completely laparoscopicly repaired.All the patients`symptomswere improved after operation.There was no hernia recurrence during the follow-up period.Conclusion Patients with type Ⅲ and Ⅳ hiatal hernias should be surgical treated earlier to avoid complications,and the minimally invasive technique combined with an anti-reflux procedure was safe for these patients.

关 键 词：食管裂孔疝 腹腔镜修补术 补片 胃底折叠 

分 类 号：R6[医药卫生—外科学]