食管旁疝修补术后早期常规使用上消化道造影系列检查：单机构连续病例系列研究
Early Routine Use of Upper GI Contrast Series Post Paraesophageal Hernia Repair: A Single Institution Consecutive Case Series.
作者信息
Robertson-More Connal, Prasad Shalvin, Gill Richdeep, Church Neal, Mitchell Philip, Debru Estifanos
机构信息
Department of Surgery, University of Calgary, Calgary, AB, Canada.
University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
出版信息
Surg Laparosc Endosc Percutan Tech. 2019 Jun;29(3):203-206. doi: 10.1097/SLE.0000000000000643.
INTRODUCTION
There is conflicting evidence with regard to the routine use of upper gastrointestinal contrast series in detecting early complications post paraesophageal hernia repair (PEHR).
METHODS
All cases booked for a PEHR between January 2007 and September 2015 were identified using hospital records. Standard demographic, operation, and imaging data were extracted.
RESULTS
We retrospectively identified 391 PEHR cases between January 2007 and September 2015. The mean age at the index operation was 66.7 years with a female predominance. The majority of index operations were elective and completed for a large paraesophageal hernia. Contrast studies were reported as normal in 70.6%, a leak in 0.3%, an obstruction in 27.9%, and early recurrence in 1.0%. Reoperation was required in 1.8% of cases.
CONCLUSION
Routine upper gastrointestinal contrast studies post-PEHR changed management in 0.8% of cases and were unhelpful in determining the need for early reoperation in 57.1% of cases requiring reoperation.
引言
关于在食管旁疝修补术（PEHR）后常规使用上消化道造影剂系列检查来检测早期并发症，存在相互矛盾的证据。
方法
利用医院记录识别出2007年1月至2015年9月期间所有预定进行PEHR的病例。提取标准的人口统计学、手术和影像学数据。
结果
我们回顾性地识别出2007年1月至2015年9月期间的391例PEHR病例。初次手术时的平均年龄为66.7岁，女性占多数。大多数初次手术是择期的，针对巨大食管旁疝进行。造影检查报告正常的占70.6%，有渗漏的占0.3%，有梗阻的占27.9%，早期复发的占1.0%。1.8%的病例需要再次手术。
结论
PEHR后常规的上消化道造影检查在0.8%的病例中改变了治疗方案，在57.1%需要再次手术的病例中，对于确定是否需要早期再次手术并无帮助。
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