单中心腹腔镜食管裂孔疝修补术992例

Laparoscopic repair for hiatal hernia： report of 992 cases in a single center

目的探讨腹腔镜治疗食管裂孔疝（hiatalhernia，HH）手术有效率、术后并发症以及满意度情况。方法收集2008年1月至2014年6月间食管裂孔疝992例患者临床资料，电话问卷术后症状评分、症状复发、术后并发症及满意度情况。结果858例获得随访，其中Ⅰ、Ⅱ、Ⅲ、Ⅳ型HH分别占79．8％、1．3％、17．1％、1．8％。植入补片520例。手术治疗总体有效率为96．2％，手术后患者各项症状评分均较治疗前均有显著下降。解剖复发31例，症状复发15例。术后短期及长期并发症分别为35．8％、5．6％。对手术治疗效果满意、一般、不满意率分别为91．8％、4．3％、3．9％。结论腹腔镜治疗食管裂孔疝具有微创、复发率低、并发症少、满意度高等优势。

Objective To evaluate the effectiveness and complications of laparoscopic repair for hiatal hernia. Methods The clinical data of 992 patients with hiatal hernia undergoing laparoscopic repair from Jan 2008 to June 2014 were collected and analyzed. Postoperative symptom scores, postoperative complications,recurrence rate and satisfaction were evaluated. Results 858 cases were followed up, including type I HH accounting for 79.8% ,type H for 1.3% ,type m for 17. 1%, type Ⅳ for 1. 8% respectively. HH repaired with mesh in 520 cases. The overall improvement rate was 96. 2%. Postoperative symptom scores significantly decreased. Recurrence of anatomy and symptoms were 31 and 15 cases respectively. Short-term and long-term of postoperative complications were 35.8% and 5.6% respectively. Excellent, fair and poor result were achieved in 91.8% , 4. 3%, 3.9% of postoperatively follow-up cases, respectively. Conclusion The laparoscopic approach for repair of hiatal hernias is of minimally invasive, Rower recurrence rate, less complications and high satisfaction.