目的    观察完全腹腔镜下食管裂孔疝修补联合抗反流术治疗食管裂孔疝的临床价值。方法    总结潍坊市人民医院自2008年5月至2012年8月间收治的58例食管裂孔疝病人（Ⅰ型26例，Ⅱ型8例，Ⅲ型20例，Ⅳ型4例）行完全腹腔镜下食管裂孔疝修补联合抗反流术治疗的临床资料。结果    58例手术顺利完成，无中转开腹病例，手术时间1.5～3.0 h，术中出血量50～150 mL，其中32例采用不可吸收线缝合修补疝缺口，26例应用补片修补疝缺口。58例行胃底270?部分折叠术（Toupet术）。肠道功能恢复时间24～48 h，进食时间36～72 h，术后住院时间4～6 d。随访时间1~50个月，42例病人临床症状完全消失，16例临床症状部分缓解，无明确复发病例。 结论    完全腹腔镜下食管裂孔疝修补联合抗反流术是根据病人情况采用个体化的修补方式，是一种微创、安全、有效的外科治疗。

Completely laparoscopic hiatal hernia repair with antireflux surgery：A clinical analysis of 58 patients        SUN Zuo-cheng，GAO Hong-lei，XU Wen-guang，et al. Department of General Surgery，Weifang People’s Hospital, Weifang Medical University，Weifang 261041，China
Corresponding author：SUN Zuo-cheng，E-mail：szcwy123@163.com
Abstract    Objective    To evaluate the clinical value of completely laparoscopic hiatal hernia repair with antireflux surgery. Methods    The clinical data of 58 patients (typeⅠin 26，typeⅡin 8，typeⅢ in 20，typeⅣ in 4) performed completely laparoscopic hiatal hernia repair and Toupet fundoplication from May 2008 to August 2012 in Weifang People’s Hospital were analyzed. Results    All of the operation were successful within 1.5-3.0 h. Blood loss during operation procedure was 50-150 mL. Among 58 patients, nonabsorbable suture was used in 32 patients and mesh was used in 26 patients. Recovery time of intestinal tract function was 24-48 h. The time of taking liquid food was 36-72 h. The time in hospital was 5-8 d. The patients were followed up for 1 to 50 months．The symptoms of 42 patients disappeared and 16 patients were partial remission. There was no hernia recurrence．Conclusion    Completely laparoscopic hiatal hernia repair with antireflux surgery according to the conditions of patients is a minimally invasive，safe and effective surgery with a good prospect.