探讨食管裂孔疝的外科治疗方法及疗效。

回顾性分析2009年3月至2015年1月西安交通大学第一附属医院手术治疗的食管裂孔疝患者的临床资料。

共收治17例食管裂孔疝患者，其中男9例，女8例，年龄15～78岁。Ⅰ型2例，Ⅱ型1例，Ⅲ型10例，Ⅳ型4例。3例经左胸行Belsey MarkⅣ修补术；1例行开腹疝修补术；7例行腹腔镜食管裂孔疝修补术；5例行腹腔镜食管裂孔疝修补＋Nissen胃底折叠术；1例行腹腔镜食管裂孔疝修补＋Dor胃底折叠术。17例患者随访无疝复发；术后早期出现吞咽困难5例，腹胀2例，脓胸1例。

食管裂孔疝修补术疗效确切，腹腔镜手术具有微创优势，可以明显缩短手术时间及术后住院时间。

To investigate the surgical diagnosis and treatment of hiatal hernia with clinical retrospective study.

To retrospectively analyze the clinical data of the patients with hiatal hernia who received surgical operation in The 1st Affiliated Hospital of Xi′an Jiaotong University from March 2009 to January 2015.

17 patients(9 males and 8 females)were included in this study.The ages ranged from 15 to 78 years old.The categorizations were 2 with typeⅠhiatal hernia, 1 with typeⅡ, 10 with typeⅢand 4 with typeⅣ.3 patients underwent transthoracic Belsey MarkⅣrepair, 1 underwent transabdominal repair, 7 underwent laparoscopic hiatal hernia repair, 5 underwent laparoscopic repair plus Nissen fundoplication and 1 underwent laparoscopic repair plus Dor fundoplication.Gastric distension were found in 2 patients.5 patients had dysphagia, 2 patients had postoperative distension of the abdomen and 1 patient had pyothorax in the 20th day after the surgery.No recurrence of the hiatal hernia was found with the follow-up.

Hiatal hernia repair is a functional operation.Laparoscopic repair operation had advantage of minimally invasive, shortened operative time and postoperative hospital stay time.