无张力疝修补技术在腹腔镜食管裂孔疝修补中的应用

Clinical application of tension-free repair in laparoscopic hiatal hernia repair

  • 摘要: 目的 探究腹腔镜食管裂孔无张力疝修补的临床效果。 方法 回顾性分析2010年7月-2014年10月在解放军总医院普通外科接受腹腔镜食管裂孔疝修补术的74例患者的临床资料及随访结果。 结果 74例手术均顺利完成。手术时间85 ~185(107.3±5.6) min,术中出血量30 ~ 120(67.2±7.5) ml。术后住院3 ~ 9 d。所有手术均放置食管裂孔疝专用补片予修补并加固食管裂孔,术后随访期间未发生补片引起的并发症。74例患者随访3 ~ 53(31.0±2.1)个月。66例(89%)术后主要症状得到缓解,8例患者术后仍有术前不适症状,烧心反酸2例、胸骨后疼痛4例、恶心呕吐1例、吞咽困难2例。术后3个月复查上消化道钡剂检查,无复发情况。 结论 腹腔镜下食管裂孔疝无张力修补术具备安全性、微创性、有效性和可行性的优势,具有进一步发展和推广的价值。

     

    Abstract: Objective To detect clinical outcome of laparoscopic hiatal hernia tension-free repair. Methods Clinical data and follow-up results of 74 patients who underwent laparoscopic hiatal hernia repair in our hospital from July 2010 to October 2014 were analyzed retrospectively. Results All operations were accomplished successfully with an average operation time of 85-185(107.3±5.6) min, an average operative blood loss of 30-120 (67.2±7.5) ml and an average hospital stay of 3-9 d. Hiatus hernia special patches were placed to repair and reinforce the esophageal hiatus with none complications caused by patch occurred during postoperative follow-up in all operations. Follow up time of 74 patients were 3 -53 (31.0±2.1) months. The main symptoms of 66 cases (89%) were alleviated postoperatively, 8 patients still had preoperative main symptoms, heartburn and acid reflux were found in 2 cases, chest pain in 4 cases, nausea and vomiting in 1 case and dysphagia in 2 cases. None HH recurrence occurred as a result of 3 months postoperative digestive barium meal examination. Conclusion Laparoscopic hiatal hernia tension-free repair has the advantages of safety, minimally invasion, effectiveness and feasibility, which is worthy of further development and promotion.

     

/

返回文章
返回