摘要
目的探讨腹腔镜食管裂孔疝修补联合抗反流手术治疗食管裂孔疝的疗效。方法 2004年5月~2008年11月45例食管裂孔疝行腹腔镜食管裂孔疝修补联合抗反流手术。采用视觉模拟积分（visual analogue scales,VAS）评价术前及术后1、6、12个月胃食管反流症状,包括烧心、吞咽梗阻、反酸、胸痛、嗳气等。结果在缝合缩小食管裂孔的同时,行改良Nissen术9例,Toupet术10例,Dor术26例。无中转开腹。手术时间92~203min,平均118min。术后住院2~8d,平均2.7d。术后发生胃潴留3例,吞咽梗阻2例。术后随访1~48个月,平均21.5月,2例分别在术后1、12个月复发。胃食管反流综合症状VAS评分术前中位数5分（4~8分）,术后1、6、12个月中位数均为1分,术前后比较均有统计学意义（P=0.000）。结论腹腔镜食管裂孔疝修补联合抗反流手术是治疗食管裂孔疝的有效方法 ,具有创伤小、恢复快的特点。
Objective To investigate the efficacy of laparoscopic repair for esophageal hiatal hernia.Methods A total of 45 cases（34 male and 11 female,aged 40-78 years）of esophageal hiatal hernia,including 12 cases of typeⅠ,26 cases of typeⅡ,and 7 case of type Ⅲ,underwent laparoscopic hernia repair and fundoplication from May 2004 to December 2008 in this division.Symptoms of gastroesophageal reflux disease,including heart burn,dysphagia,regurgitation,chest pain,and belching,were evaluated by using visual analogue scales（VAS）preoperatively,and 1,6 and 12 months postoperatively.Results In the patients,laparoscopic Nissen total fundoplication was performed as well in 9 cases,Toupet partial fundoplication in 10 cases,and Dor partial fundoplication in 26 cases.None of the cases was converted to open surgery.The operation time in this series ranged from 92 to 203 min（mean,118 min）.The mean postoperative hospital stay was 2.7 days（ranged from 2 to 8 days）.After the operation,3 patients developed gastric retention,and 2 had dysphagia.The patients were followed up for 1 to 48 months with a mean of 21.5 months,during which recurrence was found in 2 cases in 1 or 12 months postoperatively.The VAS scores decreased from a medium preoperative score of 5（4-8）to 1 at after the surgery（P=0.000,detected at 1,6 and 12 months respectively）.Conclusion Laparoscopic repair of esophageal hiatal hernia has the advantages of minimal invasion,quick recovery and good efficacy.
出处
《中国微创外科杂志》
CSCD
2010年第8期688-690,共3页
Chinese Journal of Minimally Invasive Surgery
基金
上海市重点学科建设项目
项目编号:B116
关键词
食管裂孔疝
腹腔镜
胃食管反流性疾病
Esophageal hiatal hernia
Laparoscopy
Gastroesophageal reflux disease
