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食管裂孔疝中的胸腔内胃:腹腔镜修补术的作用

Intrathoracic stomach in hiatal hernia: the role of laparoscopic repair.

作者信息

Castelijns Petrus S, Ponten Jeroen E, Bouvy Nicole D, Smulders Johannes F, van de Poll Marcel C

机构信息

Department of Surgery, MUMC+ Hospital, Maastricht, The Netherlands.

Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.

出版信息

Minerva Chir. 2018 Feb;73(1):64-76. doi: 10.23736/S0026-4733.17.07574-5. Epub 2017 Dec 14.

Abstract

INTRODUCTION

For decades, intrathoracic stomach has been an indication for surgical repair and over time laparoscopy has become standard treatment. However, there are still many aspects in the treatment of intrathoracic stomach that are subject of debate. We performed a literature review to discuss the role of laparoscopy in intrathoracic stomach repair.

EVIDENCE ACQUISITION

We performed an extensive literature search in Pubmed, Embase and Cochrane and reviewed studies from the last 5 years. To provide a complete overview, references from the found studies are also used. All data was compiled into a review format.

EVIDENCE SYNTHESIS

Laparoscopic surgery is proven to be superior to open hiatal hernia repair in the treatment of intrathoracic stomach. The role of hernia sac excision, short esophagus, mesh reinforcement, fundoplication, complications and future perspectives are discussed in this review.

CONCLUSIONS

Laparoscopy plays a major role in the treatment of intrathoracic stomach and regarding most aspects of the treatment. All available techniques have their advantages and disadvantages, and the decision on how to repair the intrathoracic stomach, remains a tailored based decision.

摘要

引言

几十年来,胸内胃一直是手术修复的适应证,随着时间的推移,腹腔镜手术已成为标准治疗方法。然而,胸内胃的治疗仍有许多方面存在争议。我们进行了一项文献综述,以讨论腹腔镜在胸内胃修复中的作用。

证据获取

我们在PubMed、Embase和Cochrane上进行了广泛的文献检索,并回顾了过去5年的研究。为了提供完整的概述,还使用了所发现研究的参考文献。所有数据都汇编成综述形式。

证据综合

在胸内胃的治疗中,腹腔镜手术已被证明优于开放性食管裂孔疝修补术。本综述讨论了疝囊切除、短食管、补片加强、胃底折叠术、并发症及未来展望的作用。

结论

腹腔镜在胸内胃的治疗及大多数治疗方面发挥着重要作用。所有可用技术都有其优缺点,如何修复胸内胃的决定仍然是基于个体化的决定。

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