摘要
目的探讨腹腔镜食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝疾病的可行性和临床应用价值。方法回顾性分析了潍坊市人民医院于2010年9月～2012年6月采用腹腔镜技术治疗的65例食管裂孔疝患者资料。其中Nissen全360。胃底折叠术24例，Toupet270。胃底折叠术20例，Dor前180。胃底折叠术21例，52例应用补片修补裂孔，剩余患者丝线缝合裂孔。结果手术顺利，无中转开腹者。术后随访3～20个月，手术效果满意率92．31％，术后3个月复查胃镜、上消化道造影等检查基本恢复正常。其中11例患者术后早期出现轻度反酸、烧心症状，6例4个月内自行缓解，3例出现吞咽困难（Nissen组2例，Toupet组1例），l例出现严重反酸、腹胀（Dor组），1例疝复发（Dor组，单纯丝线缝合裂孔）。结论腹腔镜食管裂孔疝修补和胃底折叠术治疗食管裂孔疝疾病有微创手术创伤小、恢复快、安全可行、疗效可靠等特点，胃底折叠术式根据病人具体情况应用。
Objective To explore the feasibility and clinical value of laparoseopic hiatal hernia repair and fundoplication for the treatment of esophageal hiatal hernia. Methods The clinical data of 65 patients who underwent laparoscopic surgery for esophageal hiatal hernia from September 2010 to June 2012 at our hospital were retrospectively analyzed, including 24 cases of Nissen fundoplication,20 Toupet fundoplieation,and 21 anterior 180 degrees partial fumtoplieation. Results All operations were performed smoothly,no conversions were nee- ded. After the follow up period of 3 months - 20 months, the satisfaction rate of operation was 92.31%. The symptoms in most eases were ade- quately relieved ＇after operation. Endoscopy,radiology. were repeated 3 months after surgery. Eleven cases had mild symptom recurrence of acid reflux,6 cases relieved within 4 months,developed dysphagia occurred in 3 eases（ 2 in the Nissen group and 1 in the Dot group） , 1 case had severly acid reflux and distention（ Dot group） ,and hital hernia recurrence occurred in I case（ Dot group）. Conclusion Laparoscopic repair of esophageal hiatal hernia and fundoplieatinn has the following advantages：minimized trauma,quick recovez＇y,Safe and reliable effect proce- dures for hiatal hernia. Fundoplication can be choose according to the conditions of the patient.
出处
《潍坊医学院学报》
2013年第2期133-135,共3页
Acta Academiae Medicinae Weifang
