腹腔镜膈疝修补术的临床疗效

Clinical efficacy of laparoscopic diaphragmatic hernia repair

    摘要
  • 摘要: 目的:探讨腹腔镜膈疝修补术的临床疗效。
    方法:回顾性分析2011年8月至2015年6月新疆维吾尔自治区人民医院收治的15例行腹腔镜膈疝修补术的后天性膈疝患者的临床资料。用双面复合材料补片，以疝环口为中心，使用腹腔镜下疝螺旋钉将补片固定于膈肌上，以达到修补缺损的目的。采用电话和门诊方式进行随访，随访内容包括患者术后疝复发和并发症情况，随访时间截至2015年8月。正态分布的计量资料以平均数(范围)表示。
    结果:15例膈疝患者成功行腹腔镜膈疝无张力修补术，平均手术时间为134.5 min(120.0~150.0 min)，术中平均出血量为25.6 mL(10.0～50.0 mL)，术后平均住院时间为5 d(10～12 d)。15例患者术后未出现呼吸、消化系统并发症，术前存在的呼吸系统症状(咳嗽、咳痰、喘息、憋气等)缓解，以及部分患者出现的消化系统症状(恶心、呕吐、吞咽困难等)缓解。15例患者均获得随访，随访时间为2～48个月。截至随访时间，15例患者未出现严重术后并发症，无一例复发。
    结论:腹腔镜膈疝修补术安全、可靠。

     

    Abstract: Objective:To investigate the clinical efficacy of laparoscopic diaphragmatic hernia repair.
    Methods:The clinical data of 15 patients who underwent laparoscopic repair for acquired diaphragmatic hernia at the People′s Hospital of Xinjiang Uyghur Autonomous Region from August 2011 to June 2015 were retrospectively analyzed. Twoside composite patch at the hernia ringcenter was fixed on the diaphragm using laparoscopic hernial screw nail for defect repair. The followup was performed by telephone interview and outpatient examination till August 2015, which included postoperative recurrence of hernia and complications. Measurment data with normal distribution were presented as mean value (range).
    Results:Fifteen patients received successful laparoscopic repair for tensionfree diaphragmatic hernia. The operation time, volume of intraoperative blood loss and average duration of hospital stay were 134.5 minutes (range, 120.0-150.0 minutes), 25.6 mL (range, 10.0-50.0 mL) and 5 days (range, 10-12 days), respectively. No postoperative complications of respiratory and digestive system in 15 patients were detected, and there were the remissions of preoperative respiratory symptoms (cough, cough sputum, wheezing and suffocating) and digestive symptoms (nausea, vomiting and acataposis) of some patients. All the 15 patients were followed up for 2-48 months without severe postoperative complications and recurrence.
    Conclusion:Laparoscopic diaphragmatic hernia repair is safe and feasible.

     

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