Silecchia Gianfranco, Iossa Angelo, Cavallaro Giuseppe, Rizzello Mario, Longo Fabio
Department of Medico-Surgical Sciences and Biotechnologies, Division of General Surgery & Bariatric Center of Excellence, University of Rome , Latina , Italy.
Minim Invasive Ther Allied Technol. 2014 Oct;23(5):302-8. doi: 10.3109/13645706.2014.909853. Epub 2014 Apr 29.
To report the results of an open label prospective study on a new technique for laparoscopic hiatal hernia (HH) repair with absorbable mesh fixed with absorbable materials Methods: From January 2011 to May 2013, 43 patients were treated; group A, 20 patients submitted to laparoscopic sleeve gastrectomy (LSG); group B, 13 patients submitted to revisional surgery for the diagnosis of HH and symptomatic GERD post-LSG; and group C, ten patients submitted to 360° fundoplication. All patients underwent cruroplasty reinforced with bio-absorbable mesh fixed with absorbable tacks and/or fibrin glue. Conversion rate, intra-operative complications, operative time (tacks vs tacks plus fibrin glue), perioperative complications, perioperative symptoms and radiological control set the criteria for clinical/surgical evaluation.
Conversion and mortality rate was 0%. The mean time for mesh fixation with the tacks vs tacks plus fibrin glue was 6.2 ± 2 vs 7.3 ± 3 min. The remission of GERD symptoms was observed in 39 patients, and we did not observe any cases of mesh-related complications at a mean follow-up of 17.4 months. Recurrence rate was 2.3% (one asymptomatic patient of group B).
Reinforcement with absorbable mesh-cancel bio mesh is a safe and effective option for laparoscopic HH repair in normal weight and obese patients.
报告一项关于使用可吸收材料固定可吸收补片的腹腔镜食管裂孔疝（HH）修补新技术的开放标签前瞻性研究结果。
2011年1月至2013年5月，共治疗43例患者；A组，20例行腹腔镜袖状胃切除术（LSG）；B组，13例因LSG术后诊断为HH和有症状的胃食管反流病而行翻修手术；C组，10例行360°胃底折叠术。所有患者均接受用可吸收钉和/或纤维蛋白胶固定的生物可吸收补片加强的食管裂孔修补术。转换率、术中并发症、手术时间（使用钉与使用钉加纤维蛋白胶）、围手术期并发症、围手术期症状和影像学检查作为临床/手术评估标准。
转换率和死亡率为0%。使用钉固定补片与使用钉加纤维蛋白胶固定补片的平均时间分别为6.2±2分钟和7.3±3分钟。39例患者的胃食管反流病症状缓解，平均随访17.4个月时未观察到任何补片相关并发症病例。复发率为2.3%（B组1例无症状患者）。
对于体重正常和肥胖患者的腹腔镜HH修补术，使用可吸收补片（生物补片）加强是一种安全有效的选择。
