腹腔镜下食管裂孔疝修补术

Laparoscopic repair of the esophageal hiatal hernia

目的探讨腹腔镜下应用补片行食管裂孔疝无张力修补术的临床效果。方法2006年8月至2009年10月我们对46例食管裂孔疝患者在腹腔镜下进行食管裂孔疝应用补片无张力修补，并同期给予部分胃底折叠术。结果45例患者成功地在腹腔镜下进行了无张力修补，1例患者因术中出现食道损伤，中转开胸治疗。手术时间70—210min，平均90min。术中出血10～110ml，平均25ml，均无输血。所有患者术后症状完全缓解。术后住院3～30d，平均住院日为5d。对45例患者术后进行3～25个月随访，平均12个月，未发现食管裂孔疝复发病例及有关补片并发症的发生。结论腹腔镜下食管裂孔疝无张力修补术是一种安全有效的微创方法，具有创伤少、恢复快、术后复发率低等特点。

Objective To investigate the clinical effects of laparoscopic tension - free repair of esophageal hiatal hernia using mesh. Methods From August 2006 to October 2009,46 patients with esophageal hiatal hernia were repaired using mesh, at same time, Toupet partial fundop lication was performed. Results Forty - five patients were completed under laparoscope tension - free repair for success, one patient converted to open surgery. The operation time was 90 rain （70 -210 min） and the blood loss was between 10 - 110 ml. Symptoms of ten patients were completely relieved. The mean postoperative hospital stay was 5 days （3 ~ 30 days）. The patients were followed up for 3 ~ 25 months （mean 12 months） ,no recurrence and complication were found. Conclusion Laparoscopic mesh of tension - free prosthesis is a safe and effective minimally invasive approach with less trauma and rapid recovery and low recurrence rate.