Namgoong Jung-Man, Kim Dae-Yeon, Kim Seong-Chul, Hwang Ji-Hee
Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, Seoul, Korea.
Ann Surg Treat Res. 2014 May;86(5):264-9. doi: 10.4174/astr.2014.86.5.264. Epub 2014 Apr 24.
The aim of this study was to evaluate the surgical outcomes of laparoscopic approach for hiatal hernia (HH) in pediatric patients.
This was a retrospective study of 33 patients younger than 18 years who underwent an operation for HH between January 1999 and December 2012.
The HH symptoms were various and included regurgitation, vomiting, weight loss, cough, hoarseness, and cyanosis. Among the 33 patients, there were 25 sliding types, 1 paraesophageal type, and 7 mixed types. Open surgery (OS) and laparoscopic surgery (LS) were used in 16 and 17 patients, respectively. There were no statistically significant differences in sex, age, or body weight between the groups. The median operating time was longer in the LS group (150 minutes; range, 90-250 minutes vs. 125 minutes; range, 66-194 minutes; P = 0.028). Time to oral intake was shorter in the LS group than in the OS group (1 day; range, 1-3 days vs. 2 days; range, 1-7 days; P = 0.001) and time to full feeding was shorter in the LS group than in the OS group (6 days; range, 3-16 days vs. 10 days; range, 3-33 days; P = 0.048). There were no differences in length of hospital stay and complications between the two groups. There was no perioperative mortality or recurrence of HH.
A good surgical outcome for laparoscopic correction of HH was seen in pediatric patients.
本研究旨在评估小儿食管裂孔疝(HH)腹腔镜手术的疗效。
这是一项回顾性研究,纳入了1999年1月至2012年12月间接受HH手术的33例18岁以下患者。
HH症状多样,包括反流、呕吐、体重减轻、咳嗽、声音嘶哑和发绀。33例患者中,滑动型25例,食管旁型1例,混合型7例。分别有16例和17例患者接受了开放手术(OS)和腹腔镜手术(LS)。两组患者在性别、年龄或体重方面无统计学显著差异。LS组的中位手术时间较长(150分钟;范围90 - 250分钟,而OS组为125分钟;范围66 - 194分钟;P = 0.028)。LS组的经口进食时间比OS组短(1天;范围1 - 3天,而OS组为2天;范围1 - 7天;P = 0.001),LS组的完全喂养时间比OS组短(6天;范围3 - 16天,而OS组为10天;范围3 - 33天;P = 0.048)。两组患者的住院时间和并发症无差异。无围手术期死亡或HH复发。
小儿患者腹腔镜矫正HH的手术效果良好。