3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝53例临床分析

3D laparoscopic repair and fundoplication for esophageal hiatal hernia: A clinical analysis of 53 patients

目的探究3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝的可行性及疗效。方法回顾性分析2012年3月至2016年5月于潍坊市人民医院普外科行3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝53例患者的临床资料,总结其治疗情况。结果 53例手术均顺利完成,手术时间(121.6±17.5)min,术中出血量(51.7±6.7)mL,术后住院时间(4.3±1.6)d,无胃食管穿孔、气胸等并发症,术后3例出现吞咽困难(Nissen法2例,Toupet法1例),53例患者随访时间为24个月,随访率100%,49例患者临床症状完全消失,4例偶伴有反酸、烧心(Dor法2例,Toupet法2例),无复发病例。结论 3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝是安全、有效、可行的,可取得较好的治疗效果。

Objective To explore the feasibility and curative effect of 3D laparoscopic hiatal hernia repair and fundoplication for the treatment of esophageal hiatal hernia.Methods Fifty-three patients who recieved 3D laparoscopic repair and fundoplication for esophageal hiatal hernia from March 2012 to May 2016 in Department of General Surgery of Weifang People′s Hospital were retrospectively analyzed and the treatment was summarized.Results All 53 operations were completed successfully.The average operationtime was(121.6±17.5)min and the average amount of bleeding during operation was(51.7±6.7)mL.The average postoperative hospital stay was(4.3±1.6)d.There were no stomach esophagus perforation,pneumothorax and other complications.After operation,3 patients had dysphagia(2 cases in Nissen group and 1 case in Toupet group).All the patients were followed up for twenty-four months.The follow up rate was 100%.The symptoms of 49 cases disappeared,4 cases occasionally had acid reflux and heartburn(2 cases in Dor group and 2 cases in Toupet group).There were no recurrence cases.Conclusions 3D laparoscopic hiatal hernia repair and fundoplication for the treatment of esophageal hiatal hernia is safe,effective and feasible and can achieve better therapeutic effect.