Laparoscopic surgery for hiatal hernia with gastric volvulus
10.3760/cma.j.cn113855-20240411-00270
- VernacularTitle:食管裂孔疝合并胃扭转的腹腔镜手术治疗
- Author:
Lei GUAN
1
;
Yusheng NIE
;
Huiqi YANG
Author Information
1. 首都医科大学附属北京朝阳医院疝和腹壁外科，北京 100043
- Keywords:
Hernia, hiatal;
Stomach volvulus;
Herniorrhaphy;
Laparoscopy
- From:
Chinese Journal of General Surgery
2024;39(6):430-434
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility and safety of laparoscopic surgery of hiatal hernia with gastric volvulus.Methods:A retrospective study was conducted to analyze the clinical data of 29 cases of hiatal hernia with gastric volvulus undergoing laparoscopic mesh repair and fundoplication at Beijing Chao-Yang Hospital from Jun 2021 to Dec 2022. Fundoplication was performed according to esophageal motility. The general data, operation times, intraoperative blood loss, percentage of intrathoracic stomach, hernia and gastric volvulus classification, conversion to open surgery, post-operative hospital stay and complications, symptom improvement rate, post-operative satisfaction were analyzed.Results:Chronic obstruction symptoms were the most common complaint among the 29 patients. All the operations were done laparoscopicaly with no conversion case,19(65%) cases with type Ⅲ hiatal hernia, 20(70%) cases with organoaxial gastric volvulus, average operating time was (110.2±33.3)min, average blood loss was (12.6±7.0)ml, percentage of intrathoracic stomach 75.9%±15.8%, length of hernia defect was (6.6±1.2)cm, width of hernia defect was (5.0±1.1)cm .Average post-operative hospital stay was (6.4±1.7) days, perioperative complications were pneumonia(7%) ,atelectasis(7%) and gastric motility disorder(3%). All the patients were followed up for 15 to 32 months, without report of patch infection, long-term chronic pain, intestinal obstruction and hernia recurrence. Postoperative symptom improvement rate was 90%,postoperative satisfaction rate was 90%.Conclusion:Laparoscopic surgery of hiatal hernia with gastric volvulus is a safe, feasible and effective method with satisfactory results.
