不采用食管探条行腹腔镜手术治疗儿童食管裂孔疝的初步经验  

The preliminary experience of laparoscopic esophageal hiatus hernia repair in children without esophageal bougie

作　　者：陈立才 刘江斌 盛庆丰 叶国刚 吴一波 徐伟珏 黄雄 吕志宝 CHEN Licai;LIU Jiang-bin;SHENG Qing-feng(Department of General Surgery,Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院普通外科、上海交通大学医学院附属儿童医院普通外科,上海200062

出　　处：《腹腔镜外科杂志》2023年第2期81-84,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨不采用食管探条行腹腔镜食管裂孔疝修补+Nissen术治疗儿童食管裂孔疝的可行性,并总结术中经验。方法:回顾分析2011年7月至2020年6月行食管裂孔疝修补+Nissen术的33例患儿的临床资料,其中16例术中不使用食管探条(无探条组),17例使用食管探条(探条组)。记录两组手术时间、术中出血量、术后住院时间、术后食管裂孔疝复发及食管狭窄情况等。结果:两组患儿均顺利完成手术,随访18个月至8年。无探条组手术时间[(124.7±10.7)min vs.(145.5±23.9)min]、术中出血量[(5.4±2.6)mL vs.(9.1±4.8)mL]均少于探条组(P<0.05),两组术后并发症发生率、住院时间差异无统计学意义(P>0.05)。结论:腹腔镜食管裂孔疝手术中不使用食管探条是安全、有效的,但术者需具备丰富的腹腔镜操作经验。Objective:To explore the feasibility of laparoscopic esophageal hiatus repair and Nissen operation in the treatment of esophageal hiatus hernia in children without esophageal bougie and to summarize the intraoperative experience.Methods:Thirty-three children who underwent esophageal hiatal hernia repair from Jul.2011 to Jun.2020 were selected as the research objects,16 patients were operated without esophageal bougie and 17 patients used esophageal bougie.The operative time,intraoperative blood loss,postoperative hospital stay,recurrence,esophageal stenosis and other complications were recorded.Results:All operations were successfully completed.The follow-up period ranged from 18 months to 8 years.The operation time[(124.7±10.7)min vs.(145.5±23.9)min]and intraoperative blood loss[(5.4±2.6)mL vs.(9.1±4.8)mL]in the non-esophageal bougie group were less than those in the esophageal bougie group(P<0.05).There was no statistically significant difference in postoperative complications and hospital stay between the two groups(P>0.05).Conclusions:Laparoscopic esophageal hiatal hernia surgery is safe and effective without esophageal bougie,but the surgeons should have rich experience of laparoscopic operation.

关 键 词：疝 食管裂孔 腹腔镜检查 儿童 

分 类 号：R655.4[医药卫生—外科学]