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中华胃食管反流病电子杂志 ›› 2017, Vol. 04 ›› Issue (02) : 66 -68. doi: 10.3877/cma.j.issn.1674-6899.2017.02.006

所属专题: 文献

论著

3D腹腔镜与2D腹腔镜在食管裂孔疝修补术联合Nissen胃底折叠术中应用的临床疗效对比分析
艾克拜尔·艾力1, 麦麦提艾力·麦麦提明2, 克力木·阿不都热依木3,()   
  1. 1. 830001 乌鲁木齐新疆维吾尔自治区人民医院微创疝、腹壁外科
    2. 830054 乌鲁木齐新疆医科大学
    3. 830001 乌鲁木齐新疆维吾尔自治区人民医院微创疝、腹壁外科;830054 乌鲁木齐新疆医科大学
  • 收稿日期:2016-12-26 出版日期:2017-05-15
  • 通信作者: 克力木·阿不都热依木

Comparison of clinical efficacy of 3D and 2D laparoscopic in hiatal hernia repair combined with Nissen fundoplication

Aili Aikebaier·1, Maimaitiming Maimaitiaili·2, Abudureyimu Kelimu·3,()   

  1. 1. Department of Minimally Invasive Surgery & Hernia and Abdominal Wall Surgery, Xinjiang Uygur Autonomous Region People′s Hospital, Urumqi 830001, China
    2. Xinjiang Medical University, Urumqi 830054, China
    3. Department of Minimally Invasive Surgery & Hernia and Abdominal Wall Surgery, Xinjiang Uygur Autonomous Region People′s Hospital, Urumqi 830001, China; Xinjiang Medical University, Urumqi 830054, China
  • Received:2016-12-26 Published:2017-05-15
  • Corresponding author: Abudureyimu Kelimu·
  • About author:
    Corresponding author: Kelimu·Abudureyimu, Email:
引用本文:

艾克拜尔·艾力, 麦麦提艾力·麦麦提明, 克力木·阿不都热依木. 3D腹腔镜与2D腹腔镜在食管裂孔疝修补术联合Nissen胃底折叠术中应用的临床疗效对比分析[J/OL]. 中华胃食管反流病电子杂志, 2017, 04(02): 66-68.

Aili Aikebaier·, Maimaitiming Maimaitiaili·, Abudureyimu Kelimu·. Comparison of clinical efficacy of 3D and 2D laparoscopic in hiatal hernia repair combined with Nissen fundoplication[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2017, 04(02): 66-68.

目的

对比3D腹腔镜和2D腹腔镜下行食管裂孔疝修补术联合Nissen胃底折叠术的临床疗效。

方法

回顾性分析2014年9月至2016年8月,新疆维吾尔自治区人民医院行腹腔镜下食管裂孔疝修补术联合Nissen胃底折叠术的32例患者临床资料,其中3D腹腔镜组(3D组)15例和2D腹腔镜组(2D组)17例。

结果

32例患者手术均成功,未出现围手术期严重并发症,2组患者在年龄、性别及体质指数(BMI)等一般资料方面差异无统计学意义(均P>0.05);3D组患者总手术时间较2D组患者总手术时间明显缩短[(72.3±20.5)min vs(98.1±22.9)min,P=0.007)],术中平均出血量更少[(128.9±39.2)ml vs(152.8±41.5)ml,P=0.034],差异有统计学意义(P<0.05);3D组与2D组Nissen胃底折叠平均用时[(10.3±2.5)min vs(11.1±2.9)min,P=0.077],补片缝合固定平均用时[(9.3±1.8)min vs(10.1±2.2)min,P=0.057],术后平均住院时间[(4.8±1.7)d vs(5.2±2.2)d,P=0.736]及术后并发症发生率差异比较均无统计学意义(P>0.05)。

结论

腹腔镜下食管裂孔疝修补术联合Nissen胃底折叠术中,与2D腹腔镜相比,3D腹腔镜在空间定位及深度感觉方面具有明显优势,解剖层次更清晰可辨,有助于食管裂孔疝修补联合Nissen胃底折叠术精细操作,具有总手术时间短、术中出血量少等优点,值得临床推广。

Objective

To compare and analyze the clinical efficacy of 3D and 2D laparoscopic hiatal hernia repair combined with Nissen fundoplication.

Methods

A retrospective analysis on 32 patients who underwent repairing operation of hiatal hernia with Nissen fundoplication in with laparoscopic, including 3D laparoscopic group(3D group)15 cases and 2D laparoscopic group(2D group)17 cases from September 2014 to August 2016 in the People′s Hospital of Xinjiang Uygur Autonomous Region and.

Results

Two groups of patients were performed by successful surgery and did not complain about any perioperative complications.We found no significant difference in age, gender or BMI(P>0.05). The total operative time of 3D laparoscopic surgery was significantly shorter [(72.3+ 20.5)minutes vs(98.1+ 22.9)minutes, P=0.007]And the intraoperative bleeding was significantly less [(128.9+ 39.2)ml vs(152.8+ 41.5)ml, P=0.034]. The time for laparoscopic Nissen fundoplication [(10.3+ 2.5)minutes vs(11.1+ 2.9)minutes, P=0.077], patch-suturing time [(9.3+ 1.8)minutes vs(10.1+ 2.2)minutes, P=0.057], hospitalization time [(4.8+ 1.7)days vs(5.2+ 2.2)days, P=0.736]and postoperative complication rate in 3D and 2D groups showed no significant difference(P>0.05).

Conclusion

3D laparoscopic hiatal hernia repairing combined with Nissen fundoplication, which has obvious advantages in spatial location and the depth feeling, contributes to the delicate handling for hiatal hernia repair.3D operation is significantly shorter in total operative time and less bleeding, worthes clinical aplication.

表1 3D和2D腹腔镜手术病人一般资料比较(±s)
表2 3D组与2D组手术相关观察项目比较
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