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目的探讨腹腔镜食管裂孔疝修补联合胃底180°前折叠术治疗食管裂孔疝疾病的可行性和安全性。方法回顾性分析了沧州市中西医结合医院与天津南开医院2008年9月至2013年6月采用腹腔镜技术治疗的180例食管裂孔疝患者资料,其中30例应用补片修补裂孔,剩余患者丝线缝合裂孔,均加做胃底180°前折叠(Dor手术)。结果手术顺利,无中转开腹者。术后随访3~60个月,手术效果满意率92.31%,术后3个月复查胃镜、上消化道造影等检查基本恢复正常。其中7例患者术后早期出现轻度反酸、烧心症状,均在4个月内通过保守治疗好转,无复发病例,无严重吞咽困难病例。结论腹腔镜食管裂孔疝修补和胃底180°前折叠术治疗食管裂孔疝疾病有微创手术创伤小、恢复快、安全可行、疗效可靠等特点,值得临床广泛应用。
Objective To investigate the feasibility and safety of laparoscopic esophageal hiatal hernia repair combined with prefascial 180 ° fundus folding in the treatment of esophageal hiatal hernia. Methods The data of 180 patients with esophageal hiatal hernia treated by laparoscopy from September 2008 to June 2013 in Cangzhou Integrative Medicine Hospital and Tianjin Nankai Hospital were retrospectively analyzed. Among them, 30 patients were treated with patch repair and the remaining patients’ Suture holes, are done before the end of the stomach fold 180 ° (Dor surgery). Results of the operation was successful, no transit oppression who. The patients were followed up for 3 to 60 months. The satisfaction rate of operation was 92.31%. The gastroscopy and upper gastrointestinal imaging were normal after 3 months. Among them, 7 patients had mild acid reflux and heartburn symptoms early after operation, all of them improved by conservative treatment within 4 months without recurrence and without serious dysphagia. Conclusion laparoscopic esophageal hiatal hernia repair and fundus 180 ° anterior fold in the treatment of esophageal hiatal hernia disease minimally invasive surgery trauma, fast recovery, safe and feasible, reliable and so on, it is widely used in clinical.