腹腔镜手术治疗食管裂孔疝八例体会

Experience of eight patients treated by laparoscopic esophageal hiatal hernia repair

目的探讨使用腹腔镜行食管裂孔疝修补术的疗效和安全性。方法对8例食管裂孔疝患者行腹腔镜食管裂孔疝修补术，其中3例行360°胃底折叠术，5例行270。胃底部分折叠术。4例采用丝线缝合修补食管裂孔，4例应用补片修补食管裂孔。结果8例腹腔镜食管裂孔疝修补术全部成功。手术时间平均（120±30）min，术中出血量平均（50±12）ml，无术后并发症，术后平均住院（4．5±2．5）d。术后症状完全消失7例，好转1例。随访1～2年，无复发。结论腹腔镜食管裂孔疝修补术具有疗效确定、安全和创伤小的优点，值得进一步推广应用。

Objective To explore the safety and therapeutic effect of 8 patients with esophageal Hiatal Hernia treated by laparoscopic hernia repair. Methods A retrospective analysis was performed on the clinical data of 8 patients with esophageal Hiatal Hernia form Jun. 2009 to Jun. 2010. Among the participants, 3 conducted 360-degree fundoplication,5 conducted partial（270-degree）fundoplication. Silk sutures were used for the repair of esophageal perforation in 4 patients, and patch repair was used for the other 4 cases. Results Eight patients were treated by laparoscopic hernia repair, and all of them were cured without postoperative complications. The mean duration of surgery was （ 120 ~ 30 ） min, with average blood loss （ 50 ＋ 12 ） ml. Patients had a mean postoperative hospital stay of（4. 5 ~ 2. 5 ） days. All the patients were followed up for 1 to 2 years, and no case was found to be relapsed. Conclusion Total laparoscopic hernia repair is minimally invasive,with short recovery course, less pain after surgery,little complication and short hospitalized time. Laparoscopic Hernia repair should be the preferred effective operation method for patients with esophageal Hiatal Hernia.