Department of Hernia and Abdominal Wall Surgery, The Capital Medical University Beijing Chaoyang Hospital, Jingyuan Road No.5, Shijingshan District, Beijing, 100043, China.
BMC Surg. 2021 Mar 22;21(1):158. doi: 10.1186/s12893-021-01151-0.
Laparoscopic paraesophageal hernia repair is associated with higher recurrence rate. Mesh is used to reduce the recurrence rate. This retrospective study is to review our experience of biological mesh fixed with suture and medical glue in hiatal hernias repairs.
A retrospective chart review was conducted for a consecutive series of patients undergoing laparoscopic hiatal herniorrhaphy between January 2018 and January 2019. After hiatus closure, a piece of biological prosthesis was fixed with medical glue and suture for reinforcement of the crural closure. Clinical outcomes were reviewed, and data were collected regarding operative details, complications, symptoms, and follow-up imaging. Radiological evidence of any size of hiatal hernia was considered to indicate a recurrence.
Thirty-six patients underwent surgery uneventfully without any serious complication. There was no mortality. The follow-up was, on average, 18.4 months, and there was no symptomatic recurrence. There was one anatomical recurrence without any related presentation. The method of mesh fixation with medical glue and suture took 12 min on average, and the handling was fairly easy.
Biological mesh fixed with suture and medical glue was safe and effective for repairing large hiatal hernias. Of course, a longer follow-up is still needed for determining long-term outcomes.
腹腔镜食管裂孔疝修补术的复发率较高。使用补片可降低复发率。本回顾性研究旨在回顾我们使用缝线和医用胶固定生物补片治疗食管裂孔疝的经验。
对 2018 年 1 月至 2019 年 1 月期间连续进行腹腔镜食管裂孔疝修补术的患者进行回顾性图表分析。关闭裂孔后，用医用胶和缝线固定一块生物假体，以加强裂孔闭合处的关闭。对临床结果进行了回顾，并收集了手术细节、并发症、症状和随访影像学等方面的数据。任何大小的食管裂孔疝的放射学证据都被认为是复发的迹象。
36 例患者手术顺利，无严重并发症，无死亡病例。平均随访时间为 18.4 个月，无症状复发。有 1 例解剖学复发，但无相关表现。医用胶和缝线固定补片的方法平均需要 12 分钟，操作相当简单。
缝线和医用胶固定生物补片治疗巨大食管裂孔疝是安全有效的。当然，仍需要更长时间的随访来确定长期结果。
