食管裂孔疝两种手术入路的临床疗效比较

doi:10.3969/j.issn.2095-378X.2017.03.006

外科研究与新技术 ›› 2017, Vol. 6 ›› Issue (3): 165-168.doi: 10.3969/j.issn.2095-378X.2017.03.006

食管裂孔疝两种手术入路的临床疗效比较

张杨杨¹, 单龄童², 浦祎玮², 李王莺³, 姚志坚⁴, 葛文⁵

1.同济大学附属东方医院心脏大血管外科,上海 200120;
2.南京医科大学第一临床医学院,南京 210029;
3.同济大学附属东方医院门诊部,上海 200120;
4.山西医科大学上海东方临床医学院,上海 200120;
5.上海中医药大学附属曙光医院胸心外科,上海 201203

收稿日期:2017-07-16 发布日期:2019-12-11
通讯作者: 葛文,电子信箱:ge-wen@sohu.com
作者简介:张杨杨(1978—),男,副主任医师,从事胸心血管外科临床工作
基金资助:
上海市教委重点学科建设项目(J50307)

Comparison of thoracic and transabdominal approches for the treatment of esophageal hiatal hernia

ZHANG Yangyang¹, SHAN Lingtong², PU Yiwei², LI Wangying³, YAO Zhijian⁴, GE Wen⁵

1.Department of Cardiovascular Surgery,East Hospital Affiliated to Tongji University, Shanghai 200120,China;
2.The First Clinical Medical College of Nanjing Medical University,Nanjing 210029,China;
3.Department of Outpatient,East Hospital Affiliated to Tongji University,Shanghai 200120,China;
4.Shanghai East Clinical Medical College of Shanxi Medical University,Shanghai 200120,China;
5.Department of Cardiothoracic Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China

Received:2017-07-16 Published:2019-12-11

摘要/Abstract

摘要： 目的比较经胸入路与经腹入路手术治疗食管裂孔疝的安全性及有效性。方法需手术治疗的各类型食管裂孔疝患者18 例,随机分为A组(10例经胸入路)和B组(8例经腹入路)。比较两组患者围手术期相关临床指标与近期随访情况。结果全组患者手术顺利,A组患者出现1例肺部感染,2例功能性胃瘫,经治疗得以恢复后出院。两组患者的手术时间、术后并发症发生率、术后引流量、术后住院时间、住院期间总费用等方面差异均无统计学意义。随访3个月主诉无明显不适,临床症状均得到有效缓解。结论两种手术入路治疗食管裂孔疝均能达到相同治疗效果,术后近期随访结果良好。

关键词: 食管裂孔疝, 手术入路, 临床疗效

Abstract: Objective To compare the safety and effectiveness of thoracic approach and transabdominal approach for the treatment of esophageal hiatus hernia.Methods Eighteen patients with esophageal hiatal hernia who underwent surgical treatment were randomly divided into group A (10 cases with thoracic approach) and group B (8 cases with transabdominal approach).The perioperative clinical indicators and short-term follow-ups of the two groups were compared.Results All the operations were successful.One case with pulmonary infection and two cases with functional gastroparesis in group A were recovered after treatment and discharged from hospital.There were no statistically significant differences in operative time,incidence rate of postoperative complications,postoperative drainage,postoperative hospital stay,and total cost of hospitalization between group A and group B.After a 3-month follow-up,there was no obvious discomfort,and clinical symptoms were effectively relieved.Conclusion These two approaches for the treatment of esophageal hiatal hernia could achieve the same effect with good short-term prognosis.

Key words: Hiatal hernia, Surgical approach, Clinical efficacy

中图分类号:

R734.2

张杨杨, 单龄童, 浦祎玮, 李王莺, 姚志坚, 葛文. 食管裂孔疝两种手术入路的临床疗效比较[J]. 外科研究与新技术, 2017, 6(3): 165-168.

ZHANG Yangyang, SHAN Lingtong, PU Yiwei, LI Wangying, YAO Zhijian, GE Wen. Comparison of thoracic and transabdominal approches for the treatment of esophageal hiatal hernia[J]. Surgical Research and New Technique, 2017, 6(3): 165-168.

参考文献

[1] Pkassas D,Rolfs TM,Schumacher FJ.Laparoscopic repair of giant hiatal hernia.A single center experience[J].Int J Surg,2015,20(1):149-152.
[2] 李俊生,张成,嵇振岭,等.食管裂孔疝修补术中补片的应用及争议[J].中华胃食管反流病电子杂志,2015,1(2):102-104.
[3] Bradley DD,Louie BE,Farivar AS,et al.Assessment and reduction of diaphragmatic tension during hiatal hernia repair[J].Surg Endosc,2015,29(4):796-804.
[4] Tolboom RC,Draaisma WA,Broeders IAMJ.Evaluation of conventional laparoscopic versus robot-assisted laparoscopic redo hiatal hernia and antireflux surgery:a cohort study[J].J Robot Surg,2016,10(1):33-39.
[5] 田昊睿,杜振宗,张立飞,等.食管裂孔疝经胸入路手术治疗21例[J].重庆医学,2015,1(23):3244-3246.
[6] Page PL,Furtado R,Hayward M,et al.Durability of giant hiatus hernia repair in 455 patients over 20 years[J].Ann R Coll Surg Engl,2015,97(3):188-193.
[7] Siow SL,Tee SC,Wong CM.Successful laparoscopic management of paraesophageal hiatal hernia with upside-down intrathoracic stomach:a case report[J].J Med Case Rep,2015,9(1):49.
[8] Chaar ME,Ezeji G,Claros L,et al.Short-term results of laparoscopic sleeve gastrectomy in combination with hiatal hernia repair:experience in a single accredited center[J].Obes Surg,2016,26(1):1-9.
[9] 田文,郗洪庆,卫勃,等.机器人辅助食管裂孔疝修补术及胃底折叠术2例报告及文献复习[J].中国实用外科杂志,2015,35(5):519-521.
[10] 苏福增,张成,克力木,等.腹腔镜Nissen Toupet和Dor胃底折叠术治疗食管裂孔疝合并胃食管反流病的疗效对比分析[J].中华胃肠外科杂志,2016,19(9):1014-1020.
[11] Watson DI,Thompson SK,Devitt PG,et al.Laparoscopic repair of very large hiatus hernia with sutures versus absorbable mesh versus nonabsorbable mesh:a randomized controlled trial[J].Ann Surg,2015,261(2):282-289.
[12] Pilone V,Vitiello A,Hasani A,et al.Laparoscopic adjustable gastric banding outcomes in patients with gastroesophageal reflux disease or hiatal hernia[J].Obes Surg,2015,25(2):1-5.

食管裂孔疝两种手术入路的临床疗效比较

Comparison of thoracic and transabdominal approches for the treatment of esophageal hiatal hernia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价

[1]	刘建新, 王正, 李建. 改良椎间孔镜手术治疗对腰椎间盘突出症患者疗效、手术结局及预后的影响[J]. 外科研究与新技术, 2020, 9(3): 166-169.
[2]	刘小明, 胡耀华, 汤世斌, 骆志权. 半钩骨腕掌关节面移植重建掌指关节缺损的临床研究[J]. 外科研究与新技术, 2019, 8(4): 230-233.
[3]	李柳, 杨雪英, 吕玉红. 微信平台在老年髋部骨折出院患者家庭养护中应用分析[J]. 外科研究与新技术, 2019, 8(4): 291-294.
[4]	谢跃华, 朱雷. 闭合复位内固定治疗Gartland Ⅱ型肱骨髁上骨折疗效观察[J]. 外科研究与新技术, 2019, 8(1): 13-16.
[5]	覃志华. 前列腺增生合并膀胱结石同期手术治疗的临床分析[J]. 外科研究与新技术, 2016, 5(4): 261-263.
[6]	赵腾飞. 内固定结合椎体成形术治疗脊柱骨折的临床效果[J]. 外科研究与新技术, 2015, 4(4): 248-250,262.
[7]	张有明高沛邱永龙. 椎体加椎间植骨融合治疗胸腰椎爆裂性骨折的临床效果分析[J]. 外科研究与新技术, 2015, 4(4): 245-247.
[8]	慕竹青. 分析卡培他滨联合奥沙利铂治疗老年胃癌患者的临床疗效[J]. 外科研究与新技术, 2015, 4(4): 233-234.
[9]	郑小娟. 临床护理路径在腹股沟斜疝手术患者护理中的应用[J]. 外科研究与新技术, 2015, 4(2): 127-128,131.
[10]	黄华溢. LCP和PFNA手术治疗股骨转子间骨折临床疗效比较[J]. 外科研究与新技术, 2015, 4(1): 27-29,47.