摘要
目的探讨腹腔镜下修补小儿食管裂孔疝的疗效。方法采用回顾性分析首都儿科研究所在2007年8月至2008年12月,采用3个trocar孔法腹腔镜下修补小儿食管裂孔疝12例。其中:滑动型(Ⅰ型)5例;食管旁裂孔疝(Ⅱ型)3例;混合型食管裂孔疝(Ⅲ型)2例;巨大型食管裂孔疝(Ⅳ型)2例。通过X线吞钡动态透视确诊,还纳疝内容物,切除疝囊,并用丝线紧缩、修补食管裂孔,全部进行了360°Nissen′s胃底折叠术。结果12例采用腹腔镜下手术修补成功,无中转开腹。手术时间50～160min,平均90 min。术中出血约10 mL。术后1～2 d开始进食,5～7 d出院,出院前均行钡剂胃食管造影,食管裂孔无明显异常。12例随访7～70个月,平均42个月,无明显反流。结论腹腔镜下修补小儿食管裂孔疝安全可靠,创伤小,手术野显露清晰,可以在治疗裂孔疝同时还可探查腹部是否有其他的畸形。
Objective To explore the curative effect of therapeutic laparoscopy of hiatus hernia in children. Methods Twelve children with hiatus hernia underwent 3-port therapeutic laparoscopy from August 2007 to December 2008 in the hospital of Capital Pediatrics Institute, including 2 cases of huge esophageal hiatus hernia. The hernial content was reduced and the defect of esophageal hiatus was repaired by using intermittent sutures and all cases underwent 360 degree Nissen＇s fundoplication. Results The laparo scopic operation was successfully completed in 12 cases,none transferred to open surgery. The operative lime ranged 50 --160 min （mean 90 min） ,and the intraoperative blood loss was about 10 mL. All the patients began to take food at 1 --2 d postoperatively, lhe duration of post operative hospitalization was 5- 7d. Follow-up examinations in the 12 patients for 7- 70 months （mean 42 months） showed no complication or recurrence and normal position of the esobphageal hiatus under fluoroscopy. Conclusion Lapa- roscopic repair of hiatus hernia in childen is feasible with advantages of clear visualization,satisfactory result and thorough abdomi- nal exploration.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第6期659-660,共2页
Chongqing medicine
关键词
腹腔镜
小儿
食管裂孔疝
laparoscopic
hiatus hernia
children
