Clinical application of laparoscopic repair of hiatal hernia with autogenous tissue

doi:10.3877/cma.j.issn.2095-8765.2022.04.003

Abstract

Abstract:

Objective

To observe the clinical effect of laparoscopic repair of esophageal hiatal hernia with autologous tissue and to explore the feasibility and safety of this operation.

Methods

Three patients who underwent esophageal hiatal hernia repair in our hospital from January 2018 to January 2020 were randomly selected. All patients were diagnosed as esophageal hiatal hernia before operation, with clear surgical indications and feasible simple hiatal repair, approved by the hospital ethics committee before operation. During the operation, the autologous tissue around the esophageal hiatus was used for reinforcement and repair, and the patients were followed up regularly in hospital after operation.

Results

Three patients undergoing surgery were regularly reviewed by our department for 1 month, 3 months, 6 months, and 1 year after surgery. There were no recurrences in imaging and clinical symptoms and no related complications. Postoperative acid reflux was significantly better than before surgery, the difference was statistically significant (P＜0.05).

Conclusion

Laparoscopic autogenous tissue repair of esophageal hiatal hernia is technically feasible, is a safe and effective treatment, and has the value of clinical promotion.

Key words: Laparoscopes, Autogenous tissue, Hernia, hiatal

Zanlin Li, Yiliang Li, Kelimu·Abudureyimu. Clinical application of laparoscopic repair of hiatal hernia with autogenous tissue[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(04): 187-191.

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URL: https://zhwsgflbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8765.2022.04.003

https://zhwsgflbdzzz.cma-cmc.com.cn/EN/Y2022/V09/I04/187

Figures/Tables 5

References 16

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指标	患者1	患者2	患者3
性别	男性	男性	女性
年龄	47岁	36岁	53岁
病程	8个月	2年	4年
术前胃镜	反流性食管炎LA-C级，慢性萎缩性胃炎，食管裂孔疝	反流性食管炎LA-A级，慢性非萎缩性胃炎	巴雷特食管、慢性非萎缩性胃炎
上消化道钡餐	食管裂孔疝，慢性胃炎	滑动性食管裂孔疝，慢性胃炎	滑动性食管裂孔疝，慢性胃炎
术前DeMesster评分（分）	65.5	72.3	47.4
术前LES静息呼吸最小值（mmHg）	0.12	1.2	1.55
术前LES静息呼吸平均值（mmHg）	6.33	7.10	6.57
术前食管裂孔疝大小（cm）	2.3	3.7	3.1
术前GERD量表评分（分）	12	14	14
术前疝分型	Ⅰ型	Ⅲ型	Ⅱ型

指标	患者1	患者2	患者3
性别	男性	男性	女性
年龄	47岁	36岁	53岁
病程	8个月	2年	4年
术前胃镜	反流性食管炎LA-C级，慢性萎缩性胃炎，食管裂孔疝	反流性食管炎LA-A级，慢性非萎缩性胃炎	巴雷特食管、慢性非萎缩性胃炎
上消化道钡餐	食管裂孔疝，慢性胃炎	滑动性食管裂孔疝，慢性胃炎	滑动性食管裂孔疝，慢性胃炎
术前DeMesster评分（分）	65.5	72.3	47.4
术前LES静息呼吸最小值（mmHg）	0.12	1.2	1.55
术前LES静息呼吸平均值（mmHg）	6.33	7.10	6.57
术前食管裂孔疝大小（cm）	2.3	3.7	3.1
术前GERD量表评分（分）	12	14	14
术前疝分型	Ⅰ型	Ⅲ型	Ⅱ型

调查项目	0 d	l d	2~3 d	4~7 d
烧心、烧灼感	0	2	3	1
反流	0	1	2	3
上腹部疼痛	3	2	1	0
睡眠障碍	0	1	2	3
使用非处方药	0	1	2	3

调查项目	0 d	l d	2~3 d	4~7 d
烧心、烧灼感	0	2	3	1
反流	0	1	2	3
上腹部疼痛	3	2	1	0
睡眠障碍	0	1	2	3
使用非处方药	0	1	2	3

项目	患者1	患者2	患者3
术后胃镜
术后3个月	慢性胃炎	慢性非萎缩性胃炎	慢性非萎缩性胃炎
术后6个月	慢性胃炎	慢性非萎缩性胃炎	慢性非萎缩性胃炎
术后12个有	慢性胃炎	慢性非萎缩性胃炎	慢性非萎缩性胃炎
术后上消化道钡餐
术后3个月	慢性胃炎	慢性胃炎	慢性胃炎
术后6个月	慢性胃炎	慢性胃炎	慢性胃炎
术后12个月	慢性胃炎	慢性胃炎	慢性胃炎
食管裂孔疝大小（cm）
术后3个月	0	0.2	0
术后6个月	0	0.2	0
术后12个月	0	0.2	0
GERD量表评分（分）
术后3个月	0	3	0
术后6个月	0	3	0
术后12个月	0	3	0

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