腹腔镜技术在巨大食管裂孔疝修补联合抗反流手术中的临床疗效分析

Clinical analysis of laparoscopic repair of giant hiatal hernia

目的探讨腹腔镜下巨大食管裂孔疝修补术临床经验和疗效。方法回顾性分析新疆维吾尔自治区人民医院,2013年7月至2016年2月住院并行腹腔镜下巨大食管裂孔疝修补联合胃底折叠术27例患者临床资料,总结上述患者术前、术后1年24 h食管p H监测、高分辨率食管测压及术后并发症等情况。结果手术时间98~150 min,术中平均出血量（50.1±22）ml,术后6~12 h拔出胃管,术后平均住院时间（4.5±2.1）d,患者术后反流症状明显改善,合并有贫血、哮喘的患者相关症状明显好转。术后无严重并发症发生,随访过程中无复发病例。结论腹腔镜下食管裂孔疝修补联合抗反流手术是治疗巨大食管裂孔疝的有效术式,具有创伤小、恢复快等特点,可作为反流症状明显的巨大食管裂孔疝患者治疗的首选,值得临床推广。

Objective To investigate the laparoscopic repair of giant hiatal hernia clinical efficacy and experience. Methods Retrospectively analyzed 27 patients from Xinjiang Uygur Autonomous Region peopled Hospital from July 2013 to February 2016 who accepted laparoscopic hiatal hernia repair with anti-reflux fundoplication surgery. Compared 24 hours esophageal pH monitoring and high resolution esophageal manometry and postoperative complications of the patients preoperative and 1 years after operation. Results The operation time was 98 to 150 min,the average bleeding was（50. 1 ±22） ml,pulling out the gastric tube time was 6 to 12 hours, the average postoperative hospitalization time was （4. 5 ± 2. 1 ） days,postoperative reflux symptoms and the merging anemia, asthma of patients symptoms all significantly improved. Conclusion Laparoscopic hiatal hernia repair with anti-reflux surgery is an effective surgical and has less trauma and faster recovery,which can be used to first choice of treatment for giant hiatal hernia,it is worthy of clinical promotion.