评价4K腹腔镜下生物补片在食道裂孔疝修补术中应用的疗效。

选取2019年8月至2020年1月湖南省脑科医院收治的106例严重胃食管反流病合并食管裂孔疝患者的病例资料进行回顾性分析。所有患者术中均采用生物补片行4K腹腔镜下食管裂孔疝修补联合胃底折叠（Nissen折叠）术。

本研究共有106例患者完成手术，手术时间为60~90 min，术中出血量10~50 ml，术后平均住院4 d。术中无迷走神经损伤发生，术后症状缓解102例（96.2%），术后发生吞咽困难10例（9.8%）。术后2周，进食后轻微梗阻者10例，予以禁食2~3 d后即可缓解。随访1~16个月，术后无出血、胃瘘、食管瘘及食管狭窄等并发症，未出现术后补片感染及需再次手术取补片者，无复发。

在4K腹腔镜下应用生物补片行食管裂孔疝无张力修补术是安全有效。

To evaluate the therapeutic effect of biological patch in 4K laparoscopic treatment of esophageal hiatal hernia repair.

A retrospective analysis of 106 patients with severe gastroesophageal reflux disease complicated with hiatal hernia admitted to Hunan Brain Hospital from August 2019 to January 2020 was used to perform 4K laparoscopic esophageal hiatus with a biological patch during the operation Hernia repair + fundus folding (Nissen folding) surgery.

A total of 106 patients completed the operation, the operation time was 60 to 90 minutes, the intraoperative blood loss was 10 to 50 ml, and the average postoperative hospital stay was 4 days. No intraoperative vagus nerve injury occurred, and the postoperative symptom relief rate was as high as 102 (96.2%).The incidence of dysphagia was 10 (9.8%). Two weeks after the operation, 10 cases had slight obstruction after eating, which could be relieved after fasting for 2 to 3 days. No patients had postoperative bleeding, gastric fistula, esophageal fistula, and esophageal stenosis after surgery. There was no postoperative patch infection and those who needed another surgery to get the patch, Follow-up until December 2020 (follow-up time 1 to 16 months), no patients relapsed.

Tension-free repair of esophageal hiatus hernia with biological patch under 4K laparoscopy is safe, effective and feasible.