Hermann Jacek, Kościński Tomasz, Malinger Stanisław, Szmeja Jacek, Monkiewicz Michał, Drews Michał
Department of General, Gastrointestinal and Plastic Surgery, Poznan University of Medical Sciences, Poland.
Wideochir Inne Tech Maloinwazyjne. 2012 Dec;7(4):311-4. doi: 10.5114/wiitm.2011.29251. Epub 2012 Jun 25.
The authors present a 32-year-old male patient with incarceration of a recurrent esophageal hiatal hernia after laparoscopic repair. A life-threatening strangulation of the stomach and the transverse colon occurred within a few days after the operation. Relapse of hiatal hernias amounts to almost half of early complications characteristic for the laparoscopic approach. General recommendations regarding surgical technique as well as perioperative care have been proposed in order to decrease the risk of relapse. Also, routine contrast radiology on the first or second day following the laparoscopic operation facilitates early diagnosis of relapse of hiatal hernia with emergent reoperation. This may result in decreased morbidity and improved overall outcome of the treatment.
作者报告了一名32岁男性患者,其复发性食管裂孔疝在腹腔镜修复术后发生嵌顿。术后数天内出现了危及生命的胃和横结肠绞窄。裂孔疝复发几乎占腹腔镜手术早期并发症的一半。为降低复发风险,已提出了关于手术技术以及围手术期护理的一般建议。此外,在腹腔镜手术后第一天或第二天进行常规造影放射学检查有助于早期诊断裂孔疝复发并紧急再次手术。这可能会降低发病率并改善治疗的总体结果。