摘要
食管裂孔疝(HH)是指胃食管交界部位通过扩张的食管裂孔突出。目前主要的治疗方式包括腹腔镜手术和机器人辅助手术。常见的手术方法包括伴胃底折叠术和补片修补术。HH的复发常由于膈肌脚张力过大或破裂、膈肌薄弱、食管长度较短、肥胖等因素引起。传统的腹腔镜手术采用不同的胃底折叠术式或机器人辅助手术在降低食管裂孔疝术后复发率方面效果并不显著。然而,一些新的手术技术如后腹直肌鞘瓣食管裂孔增强术和旋转镰状韧带瓣膈肌脚成形术在降低食管裂孔疝术后复发率方面具有潜在的优势。另外,HH修补术中使用补片能有效降低术后早期复发率。补片材料与形状的进步也推动了HH术后复发率的降低。
Hiatus hernia(HH)refers to the protrusion of the gastro-esophageal junction through an enlarged esophageal hiatus.The main treatment options include laparoscopic surgery,robotic surgery,etc.,with laparoscopic surgery accompanied by fundoplication and mesh repair being a common procedure.HH recurrence often occurs due to factors such as high or ruptured diaphragmatic tension,weak diaphragm,short esophagus,obesity,etc.Different fundoplication techniques in traditional laparoscopic surgery and roboticassisted surgery have not effectively reduced recurrence.Innovative surgical techniques such as posterior rectus sheath flap hiatal augmentation and falciform ligament flap diaphragm plication have shown promise in reducing HH recurrence after surgery.In addition,the use of patches in HH repair can effectively reduce early postoperative recurrence rates.Advances in patch materials and shapes have also contributed to the decreased recurrence rates.
作者
王俊
秦雯
崔颖
张娟
邵翔宇
李俊生
胡阳
Wang Jun;Qin Wen;Cui Ying;Zhang Juan;Shao Xiangyu;Li Junsheng;Ji Zhengling;Hu Yang(Department of Anesthesiology,surgery and Pain Management,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Hernia and Abdominal Wall Surgery,Zhongda Hospital,Southeast University,Nanjing 210009,China;Southeast University School of Medicine,Nanjing 210009,China)
出处
《中华胃食管反流病电子杂志》
2024年第3期159-162,共4页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
