急性食管旁疝修补术：与择期修补术的短期结果比较
Acute paraesophageal hernia repair: short-term outcome comparisons with elective repair.
作者信息
Staerkle Ralph F, Skipworth Richard J E, Hansen Ross D, Hazebroek Eric J, Smith Garett S, Leibman Steven
机构信息
*Department of Upper Gastrointestinal Surgery †Gastrointestinal Investigation Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.
出版信息
Surg Laparosc Endosc Percutan Tech. 2015 Apr;25(2):147-50. doi: 10.1097/SLE.0000000000000098.
BACKGROUND
In the literature, there is a wide range of reported morbidity and mortality rates after acute paraesophageal hernia (PH) repair.
MATERIALS AND METHODS
Data were collected from all patients undergoing PH repair between December 2001 and October 2011. Outcome data were compared between the acute and elective groups.
RESULTS
Over the study period, 268 patients underwent PH repair, of which 42 patients underwent acute repair compared with 226 elective repairs. Morbidity and mortality rates were both higher, albeit nonsignificantly, in the acute group (16.6% vs. 6.6%, P=0.058 and 4.8% vs. 0.4%, P=0.065, respectively).
CONCLUSIONS
Because of the poorer preoperative medical status, lower success rates of minimal access surgery, and longer inpatient stay, combined with the trends toward increased morbidity and mortality rates, of patients undergoing acute repair of PH, we would recommend routine elective laparoscopic surgery as the standard of care for individuals with symptomatic PH and minimal comorbidities.
背景
在文献中，急性食管旁疝（PH）修复术后报道的发病率和死亡率范围很广。
材料与方法
收集2001年12月至2011年10月期间所有接受PH修复的患者的数据。对急性组和择期组的结局数据进行比较。
结果
在研究期间，268例患者接受了PH修复，其中42例接受急性修复，226例接受择期修复。急性组的发病率和死亡率均较高，尽管无统计学意义（分别为16.6%对6.6%，P = 0.058；4.8%对0.4%，P = 0.065）。
结论
由于急性PH修复患者术前医疗状况较差、微创手术成功率较低、住院时间较长，再加上发病率和死亡率上升的趋势，我们建议对于有症状的PH且合并症较少的个体，常规择期腹腔镜手术作为标准治疗方法。
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