腹腔镜疝修补联合胃底折叠治疗胃食管反流病25例临床分析

doi:10.3877/cma.j.issn.1674-392X.2021.02.003

中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 128 -130. doi: 10.3877/cma.j.issn.1674-392X.2021.02.003

所属专题：经典病例；文献；

临床论著

腹腔镜疝修补联合胃底折叠治疗胃食管反流病25例临床分析

孙明明¹, 韩富华¹, 胡根¹, 黄建明¹, 邵国益¹^,^†(

), 李俊生²

^1. 214400　江苏江阴，东南大学附属江阴医院胃肠外科
^2. 210009　南京，东南大学附属中大医院普外科

收稿日期:2020-12-18 出版日期:2021-04-18
通信作者: 邵国益

Laparoscopic hernia repair combined with fundoplication for gastroesophageal reflux disease: A clinical analysis of 25 patients

Mingming Sun¹, Fuhua Han¹, Gen Hu¹, Jianming Huang¹, Guoyi Shao¹^,^†(), Junsheng Li²

^1. Departement of Gastrointestinal Surgery, Affiliated JiangYin Hospital, Southeast University, Jiangyin, Jiangyin 214400, China
^2. Departement of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing 210009, China

Received:2020-12-18 Published:2021-04-18
Corresponding author: Guoyi Shao

全文 ( ) 下载PDF ( ) 导出引用

目的

探讨腹腔镜疝修补联合胃底折叠治疗胃食管反流病的疗效。

方法

回顾性分析2017年1月至2020年5月，东南大学附属江阴医院完成的25例腹腔镜疝修补+胃底折叠治疗胃食管反流患者的临床数据，包括基本资料、手术指标、术后并发症及随访调查。

结果

25例腹腔镜抗反流手术（食管裂孔疝修补+胃底折叠术）均顺利完成，手术时间（168.5±41.1）min，术中出血量（26.0±20.3）ml，术后住院时间（4.8±1.9）d，术后1例出现反酸。25例患者随访时间为6～36个月，随访率100%，22例患者临床症状完全消失，3例偶有反酸、烧心，无复发病例。

结论

腹腔镜疝修补联合胃底折叠治疗胃食管反流安全有效、满意度高，值得临床推荐。

关键词: 食管裂孔疝, 胃食管反流, 疝修补术, 胃底折叠, 腹腔镜

Objective

To explore the effect of laparoscopic hernia repair combined with fundoplicationon gastroesophageal reflux disease.

Methods

The clinical data of 25 patients with gastroesophageal reflux disease undergoing laparoscopic hernia repair plusfundoplication from January 2017 to May 2020 in Jiangyin hospital were retrospectively analyzed, including basic information, surgical indicators, postoperative complications and follow-up investigation.

Results

25 cases of laparoscopic anti-reflux surgery (hiatal hernia repair plus fundoplication) were successfully completed. The operation time was (168.5±41.1) minutes, the intraoperative blood loss was (26.0±20.3) ml, and the postoperative hospital stay was (4.8±1.9) days. One case had acid reflux after operation. The follow-up time of 25 patients was 6 to 36 months, and the follow-up rate was 100%. The clinical symptoms of 22 patients disappeared completely, and 3 patients had occasional acid reflux and heartburn. There were no recurrences.

Conclusion

Laparoscopic hernia repair combined with fundoplication on gastroesophageal reflux is safe and effective, with high satisfaction, and is worthy of clinical recommendation.

Key words: Hernia, Gastroesophageal reflux, Hernia repair, Fundoplication, Laparoscopy

[1]	Yu HX, Han CS, Xue JR, et al. Esophageal hiatal hernia: risk, diagnosis and management[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(4): 319-329.
[2]	尹兴瑞，克力木·阿不都热依木，阿扎提江, 等. 腹腔镜下食管裂孔疝的外科治疗进展[J]. 腹腔镜外科杂志, 2015, 20(12): 943-945.
[3]	章纪叶，王知非，刘军伟, 等. 腹腔镜食管裂孔疝修补联合胃底折叠治疗胃食管反流206例[J]. 中华普通外科杂志, 2020, 35(3): 207-210.
[4]	辛维栋，魏煜程，陈立材. 腹腔镜手术治疗食管裂孔疝28例临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2015, 9(5): 384-385.
[5]	Chang CG, Thackeray L. Laparoscopic hiatal hernia repair in 221patients: outcomes and experience[J]. JSLS, 2016, 20(1). pii: e2015. 00104.
[6]	孙明明，邵国益，黄建明, 等. 腹腔镜疝修补联合Nissen胃底折叠术治疗食管裂孔疝[J/OL]. 中华胃食管反流病电子杂志, 2019, 6(1): 40-44.
[7]	Dean C, Etienne D, Carpentier B, et al. Hiatal hernias[J]. Surg Radiol Anat, 2012, 34( 4): 291-299.
[8]	Heimgartner B, Herzig M, Borbély Y, et al. Symptoms, endoscopic findings and reflux monitoring results incandidates for bariatric surgery[J]. Dig Liver Dis, 2017, 49(7): 750-756.
[9]	中国医疗保健国际交流促进会胃食管反流多学科分会. 中国胃食管反流病多学科诊疗共识中国医疗保健国际交流促进会胃食管反流多学科分会.中国胃食管反流病多学科诊疗共识[J/OL]. 中华胃食管反流病电子杂志, 2020, 7(1): 1-28.
[10]	吴伟，张艳君，田文. 食管裂孔疝的诊断与治疗研究进展[J/OL]. 中华疝和腹壁外科杂志(电子版), 2017, 11( 1): 27-30.
[11]	Murayama KM, Chand B, Kothari S, et al. Evidence-BasedApproach to Minimally Invasive Surgery[M]. Woodbury(CT): Cine-Med Inc, 2012: 47-56.
[12]	吴继敏，陈冬. 胃食管反流病外科治疗术式的演变和展望[J]. 中华外科杂志, 2020, 58(9): E004-E004.
[13]	Kessing BF, Brandonod AJ, Schijven MP, et al. Long-term effects of anti-reflux surgery on the physiology of the esophagogastric junction[J]. Surg Endosc, 2015, 29(12): 3726-3732.
[14]	Robinson B, Dunst CM, Cassera MA, et al. 20 years later: Laparoscopic fundoplication durability[J]. Surg Endosc, 2015, 29(9): 2520-2524.
[15]	Stephanidis D, Hoppe WW, Kohn GP, et al. Guidellines for Surgicaltreatmentofgastroesophagealrefluxdisease[J]. Surg Endosc, 2010, 24(11): 2647-2669.

[1]	杜晓辉, 崔建新. 腹腔镜右半结肠癌D3根治术淋巴结清扫范围与策略[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 5-8.
[2]	周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.
[3]	张焱辉, 张蛟, 朱志贤. 留置肛管在中低位直肠癌新辅助放化疗后腹腔镜TME术中的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 25-28.
[4]	王春荣, 陈姜, 喻晨. 循Glisson蒂鞘外解剖、Laennec膜入路腹腔镜解剖性左半肝切除术临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 37-40.
[5]	李晓玉, 江庆, 汤海琴, 罗静枝. 围手术期综合管理对胆总管结石并急性胆管炎患者ERCP +LC术后心肌损伤的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 57-60.
[6]	甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[7]	逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[8]	曹迪, 张玉茹. 经腹腔镜生物补片修补直肠癌根治术后盆底疝1例[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 115-116.
[9]	李凯, 陈淋, 向涵, 苏怀东, 张伟. 一种U型记忆合金线在经脐单孔腹腔镜阑尾切除术中的临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 15-15.
[10]	李三祥, 李佳, 刘俊峰, 吕东晨, 方晖东, 谭朝晖, 刘杰, 潘佐, 乔建坤. 基于CT影像的三维重建成像技术在腹腔镜大肾上腺肿瘤切除术中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 570-574.
[11]	赵佳晖, 王永兴, 彭涛, 李明川, 魏德超, 韩毅力, 侯铸, 姜永光, 罗勇. 后腹腔镜根治性肾切除手术时间延长和术中出血量增多的影响因素分析[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 575-580.
[12]	汪帮琦, 陈波特, 林浩坚, 许晖阳, 王镇伟, 袁雪峰, 林康健, 邱晓拂. 经腹入路3D腹腔镜联合输尿管硬镜同期处理肾盂输尿管连接部梗阻并肾盏结石的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 597-600.
[13]	林文斌, 郑泽源, 郑文能, 郁毅刚. 外伤性脾破裂腹腔镜脾切除术患者中转开腹风险预测模型构建[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 619-623.
[14]	牛朝, 李波, 张万福, 靳文帝, 王春晓, 李晓刚. 腹腔镜袖状胃切除联合胆囊切除治疗肥胖合并胆囊结石安全性和疗效[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 635-639.
[15]	孙秀艳, 徐庆蕾, 马鹏涛, 胡志元, 郭传真, 祝成红. 腹腔镜胃癌根治术中患者体温变化与压力性损伤及受压部位微环境的相关性分析[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 480-484.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Laparoscopic hernia repair combined with fundoplication for gastroesophageal reflux disease: A clinical analysis of 25 patients

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Laparoscopic hernia repair combined with fundoplication for gastroesophageal reflux disease: A clinical analysis of 25 patients