腹腔镜治疗成人食管裂孔疝手术适应证的选择(附20例报告)

目的探讨腹腔镜修补术治疗食管裂孔疝的适应证,总结相关临床治疗经验。方法回顾性分析武汉市中心医院疝与腹壁外科自2013年1月至2015年6月期间收治的20例食管裂孔疝病人的临床资料。结果 20例病人均行腹腔镜疝修补治疗,临床症状好转出院,其中14例行补片修补,6例行单纯缝合修补。手术时间为40~120 min,平均手术时间为75 min;失血量为10~50 ml,平均为25 ml;住院时间为3~8 d,平均为4.5 d;术后无严重并发症。术后1个月复查上消化道钡餐检查均显示疝囊复位良好。术后随访1年半,未见症状复现及疝复发。结论合理选择手术适应证是腹腔镜治疗食管裂孔疝的关键。

Selection of laparoscopic surgical indications in adult paraesophageal henia:20 cases report

Objective To investigate the indications of laparoscopic repair of paraesophageal hernia Methods The clinical data of 20 patients with paraesophageal hernia in Wuhan Central Hospital from January 2013 to June 2015 were retrospectively analyzed.Results Laparoscopic repair of 20 adult paraesophageal hernias was completed successfully,including 4 cases given mesh hepatorrhaphy and 6 cases given simple suture repair.The average operation time was 75 (40-120) min and the blood loss was 25 (10-50) mL.The median length of hospital stay was 4.5 (3-8) days,and no serious postoperative complications occurred.The median postoperative hospital stay was 4.5 days.Barium meal confirmed the hernia disappeared after one month.There was no recurrence during a follow-up period of one and a half years.Conclusions The reasonable choose of surgical indications is the key to laparoscopic repair of paraesophageal hernia.