3D腹腔镜下巨大食管裂孔疝修补术联合胃底折叠术的临床应用

Clinical application of 3D laparoscopic on large hiatal hernia repair

目的探讨3D腹腔镜下巨大食管裂孔疝修补术的临床应用价值。方法回顾性分析2015年1月至2017年1月,新疆维吾尔自治区人民医院行3D腹腔镜下巨大食管裂孔疝修补联合胃底折叠术的18例患者临床资料,总结并分析其手术时间、出血量及术后并发症等。结果 18例患者均行3D腹腔镜下巨大疝修补联合胃底折叠术,手术顺利,手术时间73～110 min,平均手术时间(72.3±20.5)min,术中平均出血量(20.1±12.0)ml,术后反流症状均较术前明显改善,无严重并发症发生,随访6～24个月,随访过程中无复发。结论 3D腹腔镜下巨大食管裂孔疝修补术能提供血管及神经清晰的三维立体视觉,拥有深度知觉和空间定位感,可更准确暴露术区而实现精准操作,提高手术效率,减少并发症的发生。但因本研究未涉及对照组,缺乏可比性,并且样本量较少,故需进一步证实此结论。

Objective To evaluate the clinical application of3D laparoscopic surgery for large hiatal hernia repair.Methods A retrospective analysis of18cases large hiatal hernia patients clinical data of the People's Hospital of Xinjiang Uygur Autonomous Region from January2015to January2017who underwent3D laparoscopic large hiatal hernia repair.We summarized the operative time,bleeding loss and postoperative complications.Results All patients underwent3D laparoscopic surgery successfully,the operation time was73～110minutes,average operation time was(72.3±20.5)minutes,the bleeding(20.1+12)ml.All patients'reflux symptoms were significantly improved.In the follow up of6～24months there were no serious complications or recurrence happened.Conclusion The repair of large hiatal hernia with3D laparoscopic could provide a three-dimensional vision of blood vessels and nerves,the depth perception,and spatial orientation for operation.It can be more accurate and precise and improve the efficiency of operation,reduce the incidence of complications.But we need to confirm its clinical application by more clinical data.