Mouroux J, Chazal M, Bernard J L, Elkaïm D, Myx A, Benchimol D, Bourgeon A, Richelme H
Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, Nice.
J Chir (Paris). 1995 Dec;132(12):461-6.
Between 1979 and May 1994, 42 patients (11 males, 31 females, mean age 72.8 +/- 12.4 years) underwent surgery for paraoesophageal hiatal hernia. In 37 cases, clinical signs had been observed for 64 months on the average: digestive (32), respiratory (15), cardiac (9). Nine patients had iron deficiency anaemia. Eighteen patients had a complication (acute obstruction: 10, haemorrhage: 6, perforation: 2, lung infection: 2). In 5 cases, the complication was the inaugural sign. Surgery was performed in a emergency situation in 5 cases and deferred emergency in 12 and surgery was elective in 25. An antireflux procedure was used in 36 cases (Lortat-Jacob (2), Toupet (5), Dor (2), Nissen-Rossetti (27)). Another procedure was also needed in 12 patients. There were no postoperative deaths and complications occurred in 6 patients (14.9%). Outcome was known in 40 patients with a mean follow-up of 40.5 months (range 3 to 140 months). Functional results was very good in 35 patients (87.5%), good in 3 (7.5%) and poor in 2 (5%). The most satisfactory immediate results were obtained for patients who had elective surgery and in those with a deferred emergency. Use of the Nissen-Rossetti procedure did not have any deleterious effect on these results and no long-term inconveniences.
1979年至1994年5月期间，42例患者（11例男性，31例女性，平均年龄72.8±12.4岁）接受了食管旁裂孔疝手术。37例患者平均已有64个月的临床症状：消化系统症状（32例）、呼吸系统症状（15例）、心脏系统症状（9例）。9例患者患有缺铁性贫血。18例患者出现并发症（急性梗阻：10例，出血：6例，穿孔：2例，肺部感染：2例）。5例患者的并发症为首发症状。5例患者在紧急情况下进行手术，12例为延期急诊手术，25例为择期手术。36例患者采用了抗反流手术（洛塔-雅各布术式（2例）、图佩术式（5例）、多尔术式（2例）、nissen-rossetti术式（27例））。12例患者还需要进行其他手术。术后无死亡病例，6例患者（14.9%）出现并发症。40例患者已知预后情况，平均随访40.5个月（范围3至140个月）。35例患者（87.5%）功能结果非常好，3例（7.5%）良好，2例（5%）较差。择期手术患者和延期急诊手术患者获得了最满意的近期效果。采用nissen-rossetti术式对这些结果没有任何不良影响，也没有长期不便之处。
