生物补片在腹腔镜食管裂孔疝修补术中的应用  

Clinical efficacy study of biological mesh application in laparoscopic hiatal hernia repair

作　　者：黄香港 赵怡欣 徐易敏 邵翔宇[2] 程滔 嵇振岭[2] 宋兴超[3] 李俊生[2] Huang Xianggang;Zhao Yixin;Xu Yimin;Shao Xiangyu;Cheng Tao;Ji Zhenling;Song Xinchao;Li Junsheng(Department of School of Medicine Southeast University,Nanjing 210014,China;Department of General Surgery,Zhongda Hospital,Southeast University,Nanjing 210014,China;Department of General Surgery,Xuzhou First peoples’Hospital,Xuzhou 221002,China)

机构地区：[1]东南大学医学院,南京210009 [2]东南大学附属中大医院普外科,南京210009 [3]徐州市第一人民医院普外科,221116

出　　处：《中华胃食管反流病电子杂志》2023年第4期176-180,共5页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2022-07-01)。

摘　　要：目的探究生物补片在腹腔镜食管裂孔疝修补术中的应用效果。方法前瞻性收集2022年1月至2023年9月在东南大学附属中大医院疝与腹壁外科就诊的60例食管裂孔疝合并胃食管反流病患者的临床资料并进行随访,所有患者均行腹腔镜食管裂孔疝修补术加胃底折叠术并且在术中应用生物补片,分别于术后第1、3、6个月进行随访,随访内容包括反酸、烧心、胸痛、呕吐、满意度、复发以及补片相关并发症,对比术前术后相关指标。结果所有患者均顺利完成手术,无中转开腹,患者术前平均年龄(61.85±15.83)岁,平均体质量指数(24.44±3.65)kg/m2,平均手术时间(125.83±45.67)min,平均疝宽度(3.10±1.27)cm,其中滑动性食管裂孔疝31例(51.67%),总住院时间(9.44±3.32)d。术后平均随访(10.68±6.15)个月,术后1个月随访完成率100%,术后3个月随访完成率98.33%,术后6个月随访完成率78.33%。患者术后反酸、烧心等胃食管反流症状较术前均明显改善,术前患者总体满意度评分为中位数3(2~4),术后6个月时患者总体满意度评分为中位数10(9~10),术后总体满意度明显提高,差异有统计学意义(P<0.05)。共有3例患者复发,其中1例患者症状学加影像学复发,没有患者发生补片相关并发症。结论在腹腔镜食管裂孔疝修补术中应用生物补片是有效的、安全的,在随访期间没有发生补片相关并发症,患者总体满意度高。当然,这需要更长时间的随访来进一步评估疗效。Objective To study the effectiveness and safety of biological mesh in laparoscopic hiatal hernia repair.Methods Prospectively collect clinical data of 60 patients with hiatal hernia combined with gastroesophageal reflux disease who were seen at the Department of Hernia and Abdominal Wall Surgery of the Affiliated Zhongda Hospital of Southeast University from Jan.1,2022,to Sept.30,2023,and follow up the patients,all of whom were treated by laparoscopic hiatal hernia repair and biological mesh was applied during the operation,respectively.All patients underwent laparoscopic hiatal hernia repair with gastric fundoplication and intraoperative reinforcement of the diaphragm with a biological mesh,and the patients were followed up at the 1st,3rd and 6th months after the operation,including acid reflux,heartburn,vomiting,chest pain,Overall satisfaction,recurrence and mesh-related complications and comparing the preoperative and postoperative indexes.Results All patients successfully completed the surgery without intermediate openings,the mean preoperative age of the patients was(61.85±15.83)years,the mean body mass index was(24.44±3.65)kg/m2,the mean operative time was(125.83±45.67)min,the mean hernia width was(3.10±1.27)cm,sliding hiatal hernia was 31(51.67%)cases,the total hospitalization time was(9.44±3.32)d,and the mean postoperative follow-up was(10.68±6.15)months,the completion rate of postoperative follow-up was 100%at 1 month after the operation,the completion rate of postoperative follow-up was 98.33%at 3 months after the operation,and the completion rate of postoperative follow-up was 78.33%at 6 months after the operation,and the patients'postoperative symptoms of acid reflux and heartburn improved significantly compared with the preoperative ones,All of them improved significantly compared with the preoperative period.The overall satisfaction score of the patients before surgery was median 3(2-4),and the overall satisfaction score of the patients at 6 months after surgery was median 10(9-10),Overall pos

关 键 词：腹腔镜 食管裂孔疝 疝修补术 生物补片 补片相关并发症 复发 

分 类 号：R655.4[医药卫生—外科学]