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find Keyword "食管裂孔疝" 12 results
  • SURGICAL REPAIR OF CONGENITAL DEFORMITIES OF DIAPHRAGM IN INFANTS AND CHILDREN

    Congenital deformities of the diaphragm include (1) Hiatus hernia; (2) Congenital diaphragmatic hernia; (3) Eventration of deaphragm. Fifty-one cases were seen by the authors in the past 30 years. Each type of the pathologic feature and the experiences in the surgical repair were suggested in this paper. Choice of an appropriate surgical procedure on the basis of its pathoanatomic and pathophysiologic features was emphasized in order to enhance the efficacy of treatment.

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • 婴幼儿腹腔镜下先天性食管裂孔疝修补术围手术期护理

    目的 总结婴幼儿腹腔镜下食管裂孔疝修补术围手术期的护理方法与经验,以提高护理质量。 方法 对2011年6月-2012年10月收治的8例先天性食管裂孔疝患儿行腹腔镜下食管裂孔疝修补术的护理方法及要点进行回顾性分析。 结果 患儿均顺利完成手术,1例术后第2天开始发热,并持续高热伴咳嗽,经补液、抗感染、雾化吸入等治疗,1周后体温恢复正常,伤口愈合良好,但仍有咳嗽,经儿内科会诊以支气管肺炎转入儿内科治疗。其他患儿无并发症发生,痊愈出院。经随访,8例患儿无腹痛腹胀,无疝复发,无食管狭窄等发生。 结论 术前加强饮食指导、体位护理、皮肤护理,术后做好呼吸道管理、胃管护理、积极抗感染治疗,预防肺部并发症等有效护理措施是婴幼儿腹腔镜下先天性食管裂孔疝修补手术成功的关键。

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  • Investigation of Application of Laparoscopic Hiatus Reconstruction with Crurosoft Patch in Elderly Patients with Gastroesophageal Reflux Disease

    ObjectiveTo investigate the clinical effects of laparoscopic hiatus reconstruction with Bard Crurosoft patch associated with Nissen fundoplication in elderly patients with gastroesophageal reflux disease (GERD). MethodsFrom July 2006 to July 2009, 22 consecutive elderly patients (≥65 years) with GERD underwent laparoscopic hiatus reconstruction associated with Nissen fundoplication, 10 of them underwent laparoscopic Crurosoft patch hiatus reconstruction (hiatus diameter≥5 cm in 2 patients, lt;5 cm in 8 patients) and 12 underwent laparoscopic simple sutured hiatus reconstruction (hiatus diameter≥5 cm in 2 patients, lt;5 cm in 10 patients). Intra and perioperative data including symptoms (heartburn, regurgitation, dysphagia, and respiratory complications), functional evaluations (esophagogastroscopy, manometric evaluations in lower esophageal segment, and 24 h pH-monitoring values) were compared and analyzed. ResultsPatients in 2 groups had similar preoperative values in demographics, symptom scores, functional evaluations, as well as operative data except for mean operative time. Three-month and 1-year follow-up after operation, the results of symptoms scores and functional evaluations of patients in 2 groups compared with preoperative values wear improved (Plt;0.05), but symptoms scores and functional evaluations of patients in patch group were evaluated to demonstrate more significant improvement than suture group (Plt;0.05). In suture group, the results of 3 months after operation were better than 1 year after operation, with statistically significant difference (Plt;0.05). Two patients underwent postoperative intrathoracic immigration of wrap in suture group, but this complication did not happen in patch group (Plt;0.05). ConclusionsLaparoscopic hiatus reconstruction with Bard Crurosoft patch associated with Nissen fundoplication is a safe and effective treatment for elderly patients(≥65 years) with GERD.

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • Laparoscopic Operation of Gastric and Gastroesophageal Junction Disease (Report of 59 Cases)

    Objective To investigate the feasibility and safety of laparoscopic operation of gastric and gastroesophageal junction diseases. Methods Between May 2004 and June 2009, 59 patients with gastric and gastroesophageal diseases were treated laparoscopically. The operative methods and maneuvers were evaluated and perioperative interventions, complications and efficacy of patients were analyzed. Results All operations were successfully completed laparoscopically except for one patient with gastric cancer who required a conversion to open surgery. No short-term complications occurred in all cases. No port transplant metastasis occurred for the patients with gastric cancer after an average of 36 months (1-60 months) follow-up. One patient died of liver metastasis 12 months after operation. The 3-year survival rate was 93.3% (14/15). Conclusion Laparoscopic surgery of the gastric and gastroesophageal junction diseases is feasible and safe with minimal invasiveness, which is worth popularizing.

    Release date:2016-09-08 10:50 Export PDF Favorites Scan
  • Research Development of The Relationship Between Hiatal Hernia and Respiratory Symptoms

    ObjectiveTo introduce the hiatal hernia (HH) and to summarize the research development of relationship between HH and respiratory symptoms. MethodsLiteratures in recent years which about relationship between HH and respiratory symptoms at home and abroad were collected and reviewed. ResultsGastroesophageal reflux disease (GERD), which always be caused by laryngeal airway and other esophageal symptoms, was a common illness and easily be misdiagnosed. One common symptom of the GERD was the HH. For those patients with reflux-associated esophageal symptoms, many of them suffered from HH. The treatment results showed that the endoscopic surgery could relieve the reflux symptom and effectively control the respiratory symptoms. ConclusionsThe HH can increase the risk of respiratory symptoms; an active treatment on the HH can relieve the respiratory symptoms, which is caused by the reflux symptom.

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  • Clinical Analysis of Laparoscopic Nissen Fundoplication for Hiatal Hernia in Elderly Patients

    ObjectiveTo present the safety and efficiency of laparoscopic Nissen fundoplication for hiatal hernia in elderly patients. MethodsClinical data of 35 elderly patients with hiatal hernia who underwent laparoscopic Nissen fundoplication in The Affiliated Hospital of Xuzhou Medical College between August 2013 and March 2014 was retrospectively analyzed. ResultsAll patients underwent laparoscopic Nissen fundoplication. The operation time was 72-minute in average (65-105 minutes) and intraoperative blood loss was 30 mL in average (10-120 mL). The mean value of postoperative hospital stay was 5-day (3-23 days). Patients' stomachs and esophagus were restored to normal position after surgery. No complication was noted except 2 patients had mild gastroesophageal reflux after operation, and 1 patient suffered from transient dysphagia after operation, all the symptoms subsided after conservative treatment. Afterwards, 33 of them achieved follow-up for 6 to 12 months (mean of 8.5 months), the other 2 patients were lost to follow-up. During the follow-up period, a questionnaire regarding to the criteria for Reflux Diagnostic Questionnaire (RDQ) score were conducted in the 33 patients, and the results showed that the symptoms including acid reflux, heartburn, chest pain, cough, dyspnea, lump sensation in the pharynx, and hoarseness were improved significantly in 6 months after operation (P<0.05), and no recurrence was found during the follow-up period. ConclusionLaparoscopic Nissen fundoplication is a safe operation for elderly patients with hiatal hernia, and it can achieve good clinical result.

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  • 微创一期治疗儿童巨大食管裂孔疝合并鸡胸一例

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  • 改良Nissen手术在滑动性食管裂孔疝治疗中的应用

    目的评价改良Nissen手术在滑动性食管裂孔疝治疗中的应用价值。 方法回顾性分析自2001年6月至2013年5月蚌埠医学院第一附属医院52例滑动性食管裂孔疝经手术治疗患者的临床资料,其中男27例、女25例,平均年龄62.13(35~84)岁。所有患者术前均行上消化道X线钡餐造影、胃镜检查确诊为滑动性食管裂孔疝,均行改良Nissen手术,即胃底上提至贲门口上方2~3 cm,包绕双层缝合固定食管180°,并置于膈肌下方。分别于术后3个月、6个月、9个月在平卧头低位下行消化道X线钡餐检查,并长期随访,以评价手术效果。 结果本组均顺利完成手术,无手术死亡,患者术前存在的食管下括约肌松弛和胃酸反流,术后均明显改善。术后平均住院时间9(5~11)d。52例患者术后2周内复查上消化道X线钡餐检查,无胃食管反流。所有患者均随访,随访时间2个月至10年。除1例术后半年并发食管狭窄外,其余患者均恢复顺利,症状消失,营养及发育好转。随访期间无复发。 结论改良Nissen手术是治疗滑动性食管裂孔疝的有效方法,加强食管下段高压区,折叠胃及贲门口置于膈肌下方,不仅能使胃还纳腹腔,同时还有抗反流的效果。

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  • 腹腔镜下食管裂孔疝修补术的临床疗效分析

    目的 回顾性分析腹腔镜下食管裂孔疝修补术的临床手术效果。 方法 回顾 2013 年 1 月—2015 年 12 月收治的 38 例食管裂孔疝患者的临床资料,其中 21 例行腹腔镜手术(腹腔镜组),17 例行开腹手术(开腹手术组),所有患者均采用食管裂孔疝专用补片修补并加固食管裂孔,缝合膈肌脚,术中行胃底折叠术抗反流(Nissen 胃底折叠术)或改良术式。对比分析两组患者情况。 结果 所有患者手术均顺利完成。腹腔镜组手术时间平均(110±5)min,术中出血量平均(70±6)mL,术后住院时间平均(8±2)d;开腹手术组手术时间平均(150±6)min,术中出血量平均(150±10)mL,术后住院时间平均(12±2)d;两组比较差异有统计学意义(P<0.05)。两组患者随访 3~36 个月,平均(20±3)个月,术后主要症状均得到缓解。腹腔镜组术后仍有术前不适症状 2 例,烧心反酸1 例,胸骨后疼痛 1 例。开腹手术组复发 1 例,胸骨后疼痛不适 4 例,反酸 3 例。 结论 腹腔镜下食管裂孔疝修补术相对开腹手术具有手术时间短、术中出血量少及并发症少等优点,值得临床推广应用。

    Release date:2017-03-27 11:42 Export PDF Favorites Scan
  • Effect of body mass index on surgical outcomes of laparoscopic surgery for esophageal hiatal hernia: A propensity score matching study

    ObjectiveTo explore the effect of body mass index (BMI) on the outcomes of laparoscopic surgery for esophageal hiatal hernia.MethodsWe divided the patients who underwent hiatal hernioraphy and fundoplication surgery in our hospital between July 2013 and June 2018 into two groups according to the BMI: a group A, BMI ≥24 kg/m2, 77 patients, 41 males, 36 females, with an average age of 42 years; a group B: BMI<24 kg/m2, 63 patients, 38 males, 25 females, with an average age of 67 years, and the age, gender, type of hiatal hernia, score of subjective feeling of symptoms, level of reflux esophagitis were analyzed with the propensity score matching method. Fifty one patients were successfully matched in each group, and the curative effect of surgery was compared between the two groups.ResultsThere was no statistical difference in the type of surgery, intraoperative complications, postoperative complications, and hospital stay between the two groups (P>0.05). The operative time of the group A was significantly longer than that of the group B (P=0.023). There was no statistical difference between the two groups in postoperative recurrence (P=0.741).ConclusionThe operative time in overweight patients is significantly longer than that in the non-overweight patients, but it has no effect on the surgical outcomes and complications.

    Release date:2020-03-25 09:52 Export PDF Favorites Scan
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