探究生物补片在腹腔镜食管裂孔疝修补术中的应用效果。

前瞻性收集2022年1月至2023年9月在东南大学附属中大医院疝与腹壁外科就诊的60例食管裂孔疝合并胃食管反流病患者的临床资料并进行随访，所有患者均行腹腔镜食管裂孔疝修补术加胃底折叠术并且在术中应用生物补片，分别于术后第1、3、6个月进行随访，随访内容包括反酸、烧心、胸痛、呕吐、满意度、复发以及补片相关并发症，对比术前术后相关指标。

所有患者均顺利完成手术，无中转开腹，患者术前平均年龄（61.85±15.83）岁，平均体质量指数（24.44±3.65）kg/m²，平均手术时间（125.83±45.67）min，平均疝宽度（3.10±1.27）cm, 其中滑动性食管裂孔疝31例（51.67%），总住院时间（9.44±3.32）d。术后平均随访（10.68±6.15）个月，术后1个月随访完成率100%，术后3个月随访完成率98.33%，术后6个月随访完成率78.33%。患者术后反酸、烧心等胃食管反流症状较术前均明显改善，术前患者总体满意度评分为中位数3（2~4），术后6个月时患者总体满意度评分为中位数10（9~10），术后总体满意度明显提高，差异有统计学意义（P<0.05）。共有3例患者复发，其中1例患者症状学加影像学复发,没有患者发生补片相关并发症。

在腹腔镜食管裂孔疝修补术中应用生物补片是有效的、安全的，在随访期间没有发生补片相关并发症，患者总体满意度高。当然，这需要更长时间的随访来进一步评估疗效。

To study the effectiveness and safety of biological mesh in laparoscopic hiatal hernia repair.

Prospectively collect clinical data of 60 patients with hiatal hernia combined with gastroesophageal reflux disease who were seen at the Department of Hernia and Abdominal Wall Surgery of the Affiliated Zhongda Hospital of Southeast University from Jan. 1, 2022, to Sept. 30, 2023, and follow up the patients, all of whom were treated by laparoscopic hiatal hernia repair and biological mesh was applied during the operation, respectively. All patients underwent laparoscopic hiatal hernia repair with gastric fundoplication and intraoperative reinforcement of the diaphragm with a biological mesh, and the patients were followed up at the 1^st, 3^rd and 6^th months after the operation, including acid reflux, heartburn, vomiting, chest pain, Overall satisfaction, recurrence and mesh-related complications and comparing the preoperative and postoperative indexes.

All patients successfully completed the surgery without intermediate openings, the mean preoperative age of the patients was (61.85±15.83) years, the mean body mass index was (24.44±3.65) kg/m², the mean operative time was (125.83±45.67) min, the mean hernia width was (3.10±1.27) cm, sliding hiatal hernia was 31(51.67%) cases, the total hospitalization time was (9.44±3.32) d, and the mean postoperative follow-up was (10.68±6.15) months, the completion rate of postoperative follow-up was 100% at 1 month after the operation, the completion rate of postoperative follow-up was 98.33% at 3 months after the operation, and the completion rate of postoperative follow-up was 78.33% at 6 months after the operation, and the patients' postoperative symptoms of acid reflux and heartburn improved significantly compared with the preoperative ones, All of them improved significantly compared with the preoperative period. The overall satisfaction score of the patients before surgery was median 3 (2-4), and the overall satisfaction score of the patients at 6 months after surgery was median 10 (9-10), Overall postoperative satisfaction was significantly higher and the difference was statistically significant (P<0.05), a total of 3 patients had recurrence, including 1 patient with symptomatic plus radiographic recurrence, and no patient had mesh-related complications.

The use of biological mesh in laparoscopic hiatal hernia repair was effective and safe, with no mesh-related complications and high overall patient satisfaction during the follow-up period, which, of course, needs to be longer.