摘要
目的：探讨腹腔镜下抗反流手术治疗胃食管反流病（GERD）合并食管裂孔疝的安全性和疗效。方法回顾性分析2005年9月至2013年8月新疆维吾尔自治区人民医院收治的650例GERD合并食管裂孔疝病人的临床资料，均行腹腔镜食管裂孔疝修补术＋胃底折叠术。结果650例均成功完成腹腔镜食管裂孔疝修补＋胃底折叠术，无一例中转开腹或开胸。其中联合手术135例，占20.8%。手术时间平均64.3（45～90）min；术中出血量平均18（5～50）mL，无术中术后输血者。术后24～48 h全流饮食。术后住院2～8 d。650例病人术后随访6个月至8年。21例术后出现吞咽困难，4例食管裂孔疝复发（折叠的胃底疝入胸腔），14例病人症状复发，6例病人出现胃肠胀气综合征。结论腹腔镜食管裂孔疝修补术＋胃底折叠术安全有效、创伤小、恢复快、并发症少，并可联合手术治疗其他疾病，是GERD合并食管裂孔疝病人的理想选择。
Objective To evaluate the efficacy and safety of laparoscopic hiatal hernioraphy plus fundoplication for gastroesophageal reflux disease （GERD）. Methods The clinical data of 650 patients underwent laparoscopic hiatal hernioraphy plus fundoplication from September 2005 to August 2013 in People’s Hospital of Xinjiang Uyghur Autonomous Region were analyzed retrospectively. Results Laparoscopic hiatal herniorrhaphy plus fundoplication were successfully performed in all 650 patients without conversion. Combined operation was performed in 135 patients （20.8%）. The average duration of operation was 64.3 min （45-90min） and the average amount of bleeding was 18 mL （5-50mL）. No intraoperative or postoperative blood transfusion. Liquid diet was used in 24-48 h after operation. Postoperative hospital stay was 2-8 d. All the patients were followed up for 6 months to 8 years. Postoperative dysphagia occurred in 21 patients. Recurrent hiatal hernia （gastric wrap herniated into the chest） occurred in 4 patients. Recurrence of symptoms occurred in 14 patients. Gas bloating syndrome occurred in 6 patients. Conclusion Laparoscopic hiatal hernioraphy plus fundoplication is safe and effective with less invasive,faster recovery,fewer complication, which can combine surgical treatment of other diseases and is the ideal choice for GERD with hiatal hernia.
出处
《中国实用外科杂志》
CSCD
北大核心
2014年第5期416-418,共3页
Chinese Journal of Practical Surgery
