An 81-year-old gentleman with congenital polycystic kidney disease presented to his primary care physician with dysphagia, gastroesophageal reflux refractory to medical management, and 11.25 kg weight loss in a 6 mo-p...An 81-year-old gentleman with congenital polycystic kidney disease presented to his primary care physician with dysphagia, gastroesophageal reflux refractory to medical management, and 11.25 kg weight loss in a 6 mo-period. A barium swallow misdiagnosed a paraesophageal hernia for a Bochdalek hernia. Herein, we highlight how a Bochdalek hernia may be disregarded in the differential diagnosis and how providers can resort to a more common diagnosis, a paraesophageal hernia, which is more frequently encountered in old age and whose radiologic appearance might mimic a Bochdalek hernia.展开更多
目的研究腔镜手术与开放手术在新生儿膈疝治疗中的效果及对并发症的影响。方法回顾性收集2012年1月至2020年2月在本院新生儿科诊治的新生儿膈疝40例,根据手术方法分为腔镜组(n=20)和开放组(n=20),腔镜组患儿应用腔镜下膈疝修补术治疗,...目的研究腔镜手术与开放手术在新生儿膈疝治疗中的效果及对并发症的影响。方法回顾性收集2012年1月至2020年2月在本院新生儿科诊治的新生儿膈疝40例,根据手术方法分为腔镜组(n=20)和开放组(n=20),腔镜组患儿应用腔镜下膈疝修补术治疗,开放组患儿应用开放性膈疝修补术治疗,比较两组患儿手术指标、术后恢复指标、并发症发生情况及复发率。结果腔镜组患儿手术时间长于开放组,差异有统计学意义(P<0.001);腔镜组患儿手术切口长度、术中出血量、机械通气时间、抗生素使用时间、术后住院时间均低于开放组,差异有统计学意义(P<0.001);两组患儿术中输血率、术中使用补片率、胸腔积液率、术后24 h PCO2水平比较,差异均无统计学意义(P>0.05);腔镜组并发症总发生率(10.00%)低于开放组(40.00%),差异有统计学意义(P<0.05);腔镜组术后3个月复发率为5.00%,略高于开放组的0,差异无统计学意义(P>0.05)。结论腔镜下膈疝修补术在新生儿膈疝治疗中疗效肯定,手术对患儿的创伤小,术后并发症少,利于患儿早日康复,值得临床推广。展开更多
文摘An 81-year-old gentleman with congenital polycystic kidney disease presented to his primary care physician with dysphagia, gastroesophageal reflux refractory to medical management, and 11.25 kg weight loss in a 6 mo-period. A barium swallow misdiagnosed a paraesophageal hernia for a Bochdalek hernia. Herein, we highlight how a Bochdalek hernia may be disregarded in the differential diagnosis and how providers can resort to a more common diagnosis, a paraesophageal hernia, which is more frequently encountered in old age and whose radiologic appearance might mimic a Bochdalek hernia.
文摘目的研究腔镜手术与开放手术在新生儿膈疝治疗中的效果及对并发症的影响。方法回顾性收集2012年1月至2020年2月在本院新生儿科诊治的新生儿膈疝40例,根据手术方法分为腔镜组(n=20)和开放组(n=20),腔镜组患儿应用腔镜下膈疝修补术治疗,开放组患儿应用开放性膈疝修补术治疗,比较两组患儿手术指标、术后恢复指标、并发症发生情况及复发率。结果腔镜组患儿手术时间长于开放组,差异有统计学意义(P<0.001);腔镜组患儿手术切口长度、术中出血量、机械通气时间、抗生素使用时间、术后住院时间均低于开放组,差异有统计学意义(P<0.001);两组患儿术中输血率、术中使用补片率、胸腔积液率、术后24 h PCO2水平比较,差异均无统计学意义(P>0.05);腔镜组并发症总发生率(10.00%)低于开放组(40.00%),差异有统计学意义(P<0.05);腔镜组术后3个月复发率为5.00%,略高于开放组的0,差异无统计学意义(P>0.05)。结论腔镜下膈疝修补术在新生儿膈疝治疗中疗效肯定,手术对患儿的创伤小,术后并发症少,利于患儿早日康复,值得临床推广。
