不同类型补片在食管裂孔疝修补术中应用的研究

A study on different types of mesh in hiatal hernia repair

目的探讨生物补片和合成补片在食管裂孔疝修补术中的临床效果。方法采用前瞻性队列研究,纳入2019年5月至2020年1月首都医科大学附属朝阳医院疝和腹壁外科收治的60例食管裂孔疝患者,分析选择应用生物补片或合成补片完成腹腔镜食管裂孔疝修补加胃底折叠术患者的临床资料,比较使用生物补片和合成补片的两组患者手术时间、术中出血量、住院时间、手术前后临床症状VAS评分、术后复发率及并发症。结果60例患者均顺利完成腹腔镜下食管裂孔疝修补术+胃底折叠术,术中均未出现脏器或血管损伤致大出血病例,未出现术中或术后死亡病例。生物补片组和合成补片组在食管裂孔疝修补术中总体修补效果差异无统计学意义(P>0.05)。术后随访6个月,未出现食管裂孔疝复发病例,未出现大量出血、气胸、胸腔积液、消化道瘘、纵隔感染或脓肿等并发症。结论生物补片和合成补片在食管裂孔疝修补术后短期临床效果无明显差别。

Objective To investigate the clinical result of biological mesh and synthetic mesh in the repair of hiatal hernia.Methods a prospective cohort study was conducted to collect and analyze the clinical data of 60 patients with hiatal hernia who were treated at Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital,Capital Medical University from May 2019 to Jan 2020.Intraoperative blood loss,hospital stay,clinical symptoms(heartburn,acid regurgitation,belching,early satiety,chest pain),VAS score,postoperative recurrence rate and complications were evaluated.Results There was no significant difference in the overall repair effect between biological mesh group and synthetic mesh group(P>0.05).All of the 60 patients underwent successful laparoscopic hiatal hernia repair and fundoplication.There were no massive bleeding caused by organ or vascular injury,and no peri-operative death.No recurrence of hiatal hernia,massive hemorrhage,pneumothorax,pleural effusion,gastrointestinal fistula,mediastinal infection or abscess were found during the follow-up of 6 months.Conclusion There is no significant difference in short-term clinical effect between the use of biological mesh and synthetic mesh after hiatal hernia repair.