CAJ | 학술논문

目的：评估气腹与腹壁悬吊无气腹结合腹腔镜食管裂孔疝修补和胃底折叠术治疗滑动型食管裂孔疝的临床价值。方法回顾性分析2012年5月至2014年5月，北京同仁医院胸外科进行的17例气腹与腹壁悬吊无气腹结合腹腔镜食管裂孔疝修补和胃底折叠术的临床资料，其中采用Nissen 术式15例，Toupet 术式2例。结果所有患者均顺利完成手术，无中转开腹，平均手术时间为45～220 min，术中出血量均小于50 ml，无术后并发症，全部治愈出院，术后平均住院时间10 d。随访时间1～24个月，16例患者临床症状完全消失，1例临床症状部分缓解，无明确复发病例。结论气腹与腹壁悬吊无气腹结合腹腔镜滑动型食管裂孔疝修补和胃底折叠术是一种安全有效的外科治疗，具有广泛的推广价值。
목적：평고기복여복벽현조무기복결합복강경식관렬공산수보화위저절첩술치료활동형식관렬공산적림상개치。방법회고성분석2012년5월지2014년5월，북경동인의원흉외과진행적17례기복여복벽현조무기복결합복강경식관렬공산수보화위저절첩술적림상자료，기중채용Nissen 술식15례，Toupet 술식2례。결과소유환자균순리완성수술，무중전개복，평균수술시간위45～220 min，술중출혈량균소우50 ml，무술후병발증，전부치유출원，술후평균주원시간10 d。수방시간1～24개월，16례환자림상증상완전소실，1례림상증상부분완해，무명학복발병례。결론기복여복벽현조무기복결합복강경활동형식관렬공산수보화위저절첩술시일충안전유효적외과치료，구유엄범적추엄개치。
Objective To evaluate the clinical value of the method of surgical treatment in patients with sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting.Methods The clinical data of 17 cases of laparoscopic esophageal hiatal hernia repair combined with and gastric folding via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting was collected between May 2012 and May 2014,including 15 cases of Nissen operation and,2 cases of Toupet operation.Results Surgeries in all patients were successfully completed,no transferring laparotomy,the average operation time was 45 to 220 minutes,intraoperative blood loss was less than 50 ml,there were no postoperative complications,all patients were cured and discharged,and the average hospitalization time was 10 days.Follow-up period was between 1 to 24 months.Clinical symptoms in 16 patients disappeared completely,and clinical symptoms in 1 case partly relieved,with no relapsed case.Conclusion Sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting is a safe and effective surgical treatment,and has wide value of popularization.