腹腔镜食管裂孔疝修补术38例体会

Experience of 38 patients under laparoscopic directly hiatal hernia repair

目的探讨腹腔镜食管裂孔疝修补术的可行性及安全性。方法回顾性分析2012年12月至2015年3月,伊犁州友谊医院开展腹腔镜食管裂孔疝修补术38例患者的临床资料。结果 38例腹腔镜直接食管裂孔疝修补全部获得成功。其中5例行胃底270°部分折叠术（Toupet术）,33例行胃底360°折叠术（Nissen术）,手术时间50~150 min,平均手术时间100 min,失血15~60 ml,术后24 h拔出胃管并全流质饮食,无术后并发症。平均住院7 d。术后随访3个月至3年,35例患者反酸、烧灼、胸痛症状较术前明显改善,3例改善欠佳,给予服用口服药物。结论食管裂孔疝腹腔镜修补技术是一种安全、可靠、有效的治疗方法。

Objective To explore the feasibility and safety of laparoscopic directly hiatal hernia repair. Methods Retrospective analysis the clinical data of 38 patients under laparoscopic hiatal hernia repair from December 2012 to March 2015. Results 38 cases of laparoscopic hiatal hernia repair all success directly. 5 routine stomach bottom part 270° fold surgery（ Toupet） 33 stomach bottom part 360° fold after operation（ Nissen） operation time on average 50 to 150 minutes,the average operation time,100 in laparoscopic hiatal hernia repair,15 to 60 ml blood loss,postoperative 24 hours to pull out the tube and liquid diet,no postoperative complications. Average hospital 7 days. Conclusion After the three months follow-up,38 cases of patients with no recurrence of 35 cases with acid reflux,chest pain obviously improved compared with preoperative,for hiatal hernia,laparoscopic hiatal hernia repair surgery is a safe,reliable,effective treatment.