食管裂孔旁疝在临床上比较少见。本文报道1例腹腔镜下原发性食管裂孔旁疝修补术，并对其临床表现、诊断及治疗等方面进行相关文献回顾。患者为73岁老年女性，术前完善胸部CT发现左侧胸腔胃底疝入，诊断为食管裂孔疝，术中则发现此为食管裂孔旁疝，而不是食管裂孔疝，该食管裂孔旁疝疝囊较大，并且黏连致密，术中采用了腹腔镜补片修补术联合胃底折叠抗反流术，手术顺利，患者恢复良好。据文献报道，食管裂孔旁疝发生率低，但易发生并发症，且术前与食管裂孔疝难以鉴别。腹腔镜手术则以其微创、安全，恢复快等优势在临床中广泛应用。

Parahiatal diaphragmatic hernias are rare entities.We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh.The current report is intended to depict the clinical profile, the diagnosis and treatment of this rare disease.A 73-year-old woman presented to us.CT scan showed a paraesophageal hernia with intrathoracic stomach.During the laparoscopic approach, A diagnosis of parahiatla hernia was made, which was distinct from the esophageal hiatal hernias.The hernia sac was large and the adhesion was intense.A laparoscopic mesh repair was performed with a composite mesh and Dor procedure.Parahiatal hernia has a low incidence rate, and prone to sever complications, usually can not be distinguished from esophageal hernia prior to operation.Laparoscopic repair of parahiatal hernia is feasible mini-invasive and safe.