3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝53例临床分析

摘要

目的 探究3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝的可行性及疗效.方法 回顾性分析2012年3月至2016年5月于潍坊市人民医院普外科行3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝53例患者的临床资料,总结其治疗情况.结果 53例手术均顺利完成,手术时间(121.6 ±17.5)min,术中出血量(51.7 ±6.7)mL,术后住院时间(4.3 ± 1.6)d,无胃食管穿孔、气胸等并发症,术后3例出现吞咽困难(Nissen法2例,Toupet法1例),53例患者随访时间为24个月,随访率100%,49例患者临床症状完全消失,4例偶伴有反酸、烧心(Dor法2例,Toupet法2例),无复发病例.结论 3D腹腔镜疝修补术联合胃底折叠术治疗食管裂孔疝是安全、有效、可行的,可取得较好的治疗效果.%Objective To explore the feasibility and curative effect of 3D laparoscopic hiatal hernia repair and fundoplication for the treatment of esophageal hiatal hernia.Methods Fifty-three patients who recieved 3D laparoscopic repair and fundoplication for esopha-geal hiatal hernia from March 2012 to May 2016 in Department of General Surgery of Weifang People′s Hospital were retrospectively an-alyzed and the treatment was summarized.Results All 53 operations were completed successfully.The average operationtime was (121.6 ±17.5)min and the average amount of bleeding during operation was(51.7 ±6.7)mL.The average postoperative hospital stay was(4.3 ±1.6)d.There were no stomach esophagus perforation,pneumothorax and other complications.After operation,3 pa-tients had dysphagia(2 cases in Nissen group and 1 case in Toupet group).All the patients were followed up for twenty-four months. The follow up rate was 100%.The symptoms of 49 cases disappeared,4 cases occasionally had acid reflux and heartburn(2 cases in Dor group and 2 cases in Toupet group).There were no recurrence cases.Conclusions 3D laparoscopic hiatal hernia repair and fun-doplication for the treatment of esophageal hiatal hernia is safe,effective and feasible and can achieve better therapeutic effect.