食管裂孔疝的腔镜修补规范化操作七步法

Seven-step procedure of standardized laparoscopic repair for hiatal hernia

食管裂孔疝(HH)是临床高发病,与腹内压力升高、食管相对短缩、裂孔周围支撑结构薄弱有关,能引起胃食管反流、吞咽异常、食管外症状等,严重危害患者健康和生命。随着诊断和治疗技术的发展,HH手术在我国不同级别医院逐渐开展。由于对疾病解剖、病理生理认识的局限性以及手术培训的欠缺,我国HH修补术后的并发症也随之增多。为规范HH腹腔镜修补操作、同质化HH腔镜手术水平以及降低术后并发症的发生,笔者循照共识、结合自身经验,提出容易掌握、推广的HH腹腔镜下修补手术操作七步法。

Hiatal hernia(HH) is a common disease in clinical practice, and is associated with high abdominal pressure, relatively shortened esophagus and weaken support tissue around the hiatus. Hiatal hernia can cause gastroesophageal reflux, abnormal swallow and ex-esophageal symptoms, which severely threaten patients’ health and longevity. With the development of diagnostic and treatment technologies, surgical repair of HH has been increasingly carried out in hospitals of different levels in China. However, the occurrence of complications after HH repair is continuously rising, due to limitations in understanding of the anatomy and pathophysiology of the disease and lack of surgical training. For standardizing the procedures of laparoscopic HH repair, homogenizing the skills of laparoscopic HH repair and decreasing postoperative complications, the authors based on the guidelines and personal experiences, propose a seven-step procedure for laparoscopic HH repair, which can be easily learned and generalized.