中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (02): 159-161.

• 论著 • 上一篇    下一篇

腹腔镜食管裂孔疝修补术143例临床分析

赵宏志,秦鸣放,王    庆,勾承月,李    宁   

  1. 天津市南开医院 天津市微创外科中心,天津300100
  • 出版日期:2011-02-01 发布日期:2011-05-30

  • Online:2011-02-01 Published:2011-05-30

摘要:

目的    探讨腹腔镜手术治疗食管裂孔疝的可行性和临床应用价值。 方法    对2001年6月至2010年2月天津市南开医院143例食管裂孔疝行腹腔镜食管裂孔疝修补术的资料进行分析。 结果    143例均完成腹腔镜手术,无中转开腹病例,手术时间55~210min,平均86 min;术中出血量40~150mL,平均76mL;术后住院时间3~21d,平均4.6d。术后临床症状均得到缓解,无严重并发症及死亡病例。134例得到随访,随访时间3个月至9年,平均3.8年,手术结果满意率91.67%。8例进固体食物时有轻度哽噎感,5例反酸症状复发,其中4例应用抑酸药物后可控制,1例行开腹手术治疗。结论    腹腔镜治疗食管裂孔疝,充分体现了手术创伤小、恢复快、安全可行、疗效可靠的特点。

关键词: 腹腔镜, 食管裂孔疝, 胃底折叠术

Abstract:

Laparoscopic hiatal hernia repair: a clinical analysis of 143 cases        ZHAO Hong-zhi, QIN Ming-fang, WANG Qing, et al. Center of Tianjin Minimally Invasive Surgery, Nankai Hospital, Tianjin 300100, China
Corresponding author : ZHAO Hong-zhi, E-mail:tjzhhzh@sina.com
Abstract    Objective    To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal hernia.  Methods    From June 2001 to February 2010, 143 cases of  hiatal hernia were enrolled to undertake laparoscopic hiatal hernia repair at Nankai Hospital of Tianjin City. Laparoscopic fundoplication was performed concomitantly in some cases if appropriate. Paraoperative clinical parameters were recorded and analyzed. All cases were followed up routinely. Clinical outcomes were collected and analyzed. Results    All 143 cases of laparoscopic operations were accomplished successfully. No conversions were needed. Mean operation time was 86 minutes (range: 55-210 minutes). Mean intraoperative blood lose was 76 mL (range: 40-150 mL). Mean postoperative hospital stay was 4.6 days (range: 3-21 days). Clinical symptoms were relieved in all cases. No mortality and severe complications were noted. Mean follow up period was 3.8 years (range: 3 months to 9 years). Rate of satisfaction for operation was 91.67%. Mild dysphagia occurred in 8 cases. Reflux recurrence occurred in 5 cases, in whom 4 cases were controlled by antacid medicine and 1 case need open surgical revision. Conclusion    Laparoscopic hiatal hernia repair has the advantages of minimal trauma, fast recovery, safe and high reliability.

Key words: laparoscopy, hiatal hernia, fundoplication