腹腔镜下食管裂孔疝的诊治进展
Progress in Diagnosis and Treatment of Laparoscopic Hiatal Hernia
DOI: 10.12677/ACM.2022.127921, PDF,   
作者: 文 森：青海大学研究生院，青海 西宁；青海大学附属医院普通外科学三科，青海 西宁；秦 伟*：青海大学附属医院普通外科学三科，青海 西宁
关键词: 疝；食管裂孔疝；腹腔镜；胃底折叠术；诊断；治疗；Hernia； Hiatal Hernia； Laparoscopy； Fundoplication； Diagnosis； Treatment
摘要: 食管裂孔疝(Hiatal Hernia, HH)是临床上常见的一种疾病，属于膈疝中最常见的类型。其发病率在我国呈现逐年上升趋势，在临床上也逐步受到了重视。其诊断方法多种多样，包括临床表现、影像学方法、内镜检查及pH监测及食管测压等方法。临床上可根据其解剖学特点分为四种类型。腹腔镜下食管裂孔疝的治疗包括腹腔镜食管裂孔疝修补及胃底折叠抗反流手术两种相结合的标准术式。其术后并发症包括出血、消化道穿孔、气胸、胸腔积液、纵膈腔积液、吞咽困难及肺栓塞等。本文就HH的诊断，分型，腹腔镜技术在食管裂孔疝的应用及手术相关并发症进行综述。
Abstract: Esophageal HiatalHernia (HH) is a common disease in clinic, which belongs to the most common type of diaphragmatic hernia. Its incidence rate is increasing year by year in China, and it has been gradually paid attention to clinically. There are various diagnostic methods, including clinical man-ifestations, imaging methods, endoscopy, pH monitoring and esophageal manometry. Clinically, it can be divided into four types according to its anatomical characteristics. Laparoscopic treatment of hiatal hernia includes laparoscopic repair of hiatal hernia and gastric fundoplication for anti-reflux surgery. Postoperative complications include hemorrhage, digestive tract perforation, pneumotho-rax, pleural effusion, mediastinal effusion, dysphagia and pulmonary embolism. This article reviews the diagnosis and classification of HH, the application of laparoscopic technique in hiatal hernia and the complications related to operation.
文章引用：文森, 秦伟. 腹腔镜下食管裂孔疝的诊治进展[J]. 临床医学进展, 2022, 12(7): 6391-6396. https://doi.org/10.12677/ACM.2022.127921

参考文献

[1] Kohn, G.P., Price, R.R., Demeester, S.R., et al. (2013) Guidelines for the Management of Hiatal Hernia. Surgical En-doscopy, 27, 4409-4428. [Google Scholar] [CrossRef] [PubMed]
[2] 孙明明, 邵国益, 黄建明, 等. 腹腔镜疝修补联合Nissen胃底折叠术治疗食管裂孔疝[J]. 中华胃食管反流病电子杂志, 2019, 6(1): 40-44.
[3] 杜智, 张成, 克力木. 滑动型食管裂孔疝长度与胃食管反流病关系的研究[J]. 临床外科杂志, 2017, 25(1): 75-77.
[4] Hoffmans, D., Dahele, M., Senan, S., et al. (2016) Can the Probability of Radiation Esophagitis Be Re-duced without Compromising Lung Tumor Control: A Radiobiological Modeling Study. Acta Oncologica, 55, 926-930. [Google Scholar] [CrossRef] 
[5] Dean, C., Etienne, D., Carpentier, B., et al. (2012) Hiatal Hernias. Surgical and Radiologic Anatomy, 34, 291-299. [Google Scholar] [CrossRef] [PubMed]
[6] Cuschieri, A. (1992) Laparoscopic Reduction, Crural Repair, and Fundoplication of Large Hiatal Hernia. American Journal of Surgery, 163, 425-430. [Google Scholar] [CrossRef] 
[7] 田文. 腹腔镜食管裂孔疝修补术[J]. 中华腔镜外科杂志(电子版), 2010, 3(2): 4-6.
[8] Matar, A., Mroue, J., Camporesi, E., et al. (2016) Large Hiatal Hernia Compressing the Heart. American Journal of Cardiology, 117, 483-484. [Google Scholar] [CrossRef] [PubMed]
[9] Mittal, S.K., Awad, Z.T., Tasset, M., et al. (2005) The Preoperative Predictability of the Short Esophagus in Patients with Stric-ture or Paraesophageal Hernia. European Journal of Radiology, 54, 448-459.
[10] Kahrilas, P.J., Kim, H.C. and Pan-dolfino, J.E. (2008) Approaches to the Diagnosis and Grading of Hiatal Hernia. Best Practice & Research Clinical Gas-troenterology, 22, 601-616. [Google Scholar] [CrossRef] [PubMed]
[11] 吴凯锴, 杨福全. 食管裂孔疝诊治进展[J]. 中国实用外科杂志, 2012, 32(6): 496-498.
[12] Eren, S., Gümü, H. and Okur, A. (2003) A Rare Cause of In-testinal Obstruction in the Adult: Morgagni’s Hernia. Hernia, 7, 97-99. [Google Scholar] [CrossRef] [PubMed]
[13] 吴伟, 张艳君, 田文. 食管裂孔疝的诊断与治疗研究进展[J]. 中华疝和腹壁外科杂志(电子版), 2017, 11(1): 27-30.
[14] 陈富强, 申英末, 陈杰. 食管裂孔疝的诊疗现状[J]. 中华胃食管反流病电子杂志, 2014, 1(1): 49-51.
[15] Khajanchee, Y.S., Cassera, M.A., Swanström, L.L., et al. (2012) Diagnosis of Type-I Hiatal Hernia: A Comparison of High-Resolution Manometry and Endoscopy. Diseases of the Esophagus, 26, 1-6. [Google Scholar] [CrossRef] [PubMed]
[16] Hyun, J.J. and Bak, Y.T. (2011) Clinical Significance of Hiatal Hernia. Gut and Liver, 5, 267-277. [Google Scholar] [CrossRef] [PubMed]
[17] Mori, T., Nagao, G. and Sugiyama, M. (2012) Paraesophageal Her-nia Repair. Annals of Thoracic and Cardiovascular Surgery, 18, 297-305. [Google Scholar] [CrossRef] [PubMed]
[18] 孙强玉, 王荣华. 食管裂孔疝的外科治疗新进展[J]. 中国现代普通外科进展, 2018, 21(1): 68-70.
[19] 刘昶, 万会魁, 纪艳超. 食管裂孔疝的微创治疗[J]. 临床外科杂志, 2011, 19(6): 372-373.
[20] 彭际奎, 王举, 王永强, 等. 腹腔镜治疗食管裂孔疝的临床分析[J]. 内蒙古医科大学学报, 2015, 37(2): 173-175.
[21] Park, A.E., Hoogerboord, C.M. and Sutton, E. (2012) Use of the Falciform Ligament Flap for Closure of the Esophageal Hiatus in Giant Paraesophageal Hernia. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 16, 1417-1421. [Google Scholar] [CrossRef] [PubMed]
[22] Stadlhuber, R.J., Sherif, A.E., Mittal, S.K., et al. (2009) Mesh Complications after Prosthetic Reinforcement of Hiatal Closure: A 28-Case Series. Surgical Endoscopy, 23, 1219-1226. [Google Scholar] [CrossRef] [PubMed]
[23] Ping, Y.E., Li, Z.S., Xu, G.M., et al. (2008) Esophageal Motility in Patients with Sliding Hiatal Hernia with Reflux Esophagitis. Chinese Medical Journal, 121, 898-903. [Google Scholar] [CrossRef] 
[24] 杨玉兵, 王耿泽, 张海洋. 腹腔镜食管裂孔疝修补联合胃底折叠术治疗胃食管反流病合并食管裂孔疝[J]. 中国普通外科杂志, 2014, 23(12): 1730-1732.
[25] Makris, K.I., Cassera, M.A., Kastenmeier, A.S., et al. (2012) Postoperative Dysphagia Is Not Predictive of Long-Term Failure after Laparoscopic Antireflux Surgery. Surgical Endoscopy, 26, 451-457. [Google Scholar] [CrossRef] [PubMed]
[26] Bell, R., Hanna, P., Mills, M.R., et al. (1999) Patterns of Success and Failure with Laparoscopic Toupet Fundoplication. Surgical Endoscopy, 13, 1189-1194. [Google Scholar] [CrossRef] 
[27] 秦鸣放, 孙向宇. 腹腔镜180˚前胃底折叠术治疗胃食管反流性疾病临床研究[J]. 中国实用外科杂志, 2009, 29(2): 138-140.
[28] 徐永波, 褚海波. 腹腔镜食管裂孔疝修补和胃底折术进展[J]. 实用医药杂志, 2005, 22(6): 553-555.
[29] 秦鸣放, 赵宏志. 腹腔镜手术治疗胃食管结合部良性疾病术后并发症及处理[J]. 中国实用外科杂志, 2013, 33(4): 295-297.
[30] Finley, C.J., Kondra, J., Clifton, J., et al. (2010) Factors Associated with Postoperative Symptoms after Laparoscopic Heller Myotomy. The Annals of Thoracic Surgery, 89, 392-396. [Google Scholar] [CrossRef] [PubMed]
[31] Gryska, P.V. and Vernon, J.K. (2005) Tension-Free Repair of Hiatal Hernia during Laparoscopic Fundoplication: A Ten-Year Experience. Hernia, 9, 150-155. [Google Scholar] [CrossRef] [PubMed]
[32] 赵宏志, 秦鸣放. 腹腔镜下巨大食管裂孔疝修补术25例[J]. 中华胸心血管外科杂志, 2011, 27(3): 152-154.
[33] Pierre, A.F., Luketich, J.D., Fernando, H.C., et al. (2002) Patients Original Articles: General Thoracic Results of Laparoscopic Repair of Giant Paraesophageal Hernias: 200 Consecutive Patients. The Annals of Thoracic Surgery, 74, 1909-1916. [Google Scholar] [CrossRef] 
[34] 赵宏志, 秦鸣放. 术中胃镜在腹腔镜上消化道手术中的应用价值[J]. 中华消化内镜杂志, 2012, 29(8): 474-475.
[35] 吴孟超, 吴在德. 黄家驷外科学[M]. 第7版. 北京: 人民卫生出版社, 2008: 2116-2117.
[36] Vega, K.J., Langford-Legg, T., Palacio, C., et al. (2013) Females without Re-flux Symptoms or Gastroesophageal Reflux Disease Have Less Distal Esophageal Acid Exposure than Males without Reflux Symptoms or Gastroesophageal Reflux Disease. Diseases of the Esophagus, 26, 246-469. [Google Scholar] [CrossRef] [PubMed]
[37] 余瑶, 时阳, 王丹. 食管裂孔疝的诊治[J]. 中华胃食管反流病电子杂志, 2018, 5(4): 183-188.
[38] 田志强, 张重阳. 腹腔镜治疗食管裂孔疝的现状与进展[J]. 中华腔镜外科杂志(电子版), 2014, 7(6): 499-501.

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