胃食管结合部腹腔镜手术的临床研究

Clinic study of laparoscopic surgery of the gastroesophageal junction

目的探讨腹腔镜下行食管裂孔疝修补术、迷走神经切断术和贲门失弛缓症肌层切开术的疗效和安全性。方法从1995年11月至2006年4月,行腹腔镜食管裂孔疝修补和胃底折叠术28例、腹腔镜迷走神经切断术24例和贲门失弛缓症肌层切开术3例。结果手术时间1.0～4.5h,平均2.5h;术后24～72h即可开始进食流质。无术后并发症,术后平均6d出院。结论腹腔镜手术治疗食管裂孔疝、十二指肠球部溃疡和贲门失弛缓症具有疗效确定、创伤小和恢复快的优点,腹腔镜手术适合用于处理胃食管结合部病变。

Objective To investigate the efficacy and safety of laparoscopic surgery of gastroesophgeal junction. Methods Twenty eight patients underwent laparoscopic paraesophageal hernia repair, 24 laparoscopic vagotomy for treatment of duodenal ulcer, and 3 laparoscopic esophagomyotomy for achalasia from Nov. 1995 to April 2006. Resuits Laparoscopy was completed in all patients, no conversion from laparoscopic to open surgery was necessary. The operation time averaged 2.5h （range1.0-4.5h）, postoperative oral feedings were resumed after 24-72h of surgery, and no postoperative complication occurred. The median postoperative hospital stay was 6d （range 4-7d ）. Conclusion Laparoscopic surgery is a effective and safe surgical procedure, and has the merit of minimal invasive surgery for correction of gastroesophageal junction pathology.