Schauer P R, Ikramuddin S, McLaughlin R H, Graham T O, Slivka A, Lee K K, Schraut W H, Luketich J D
University of Pittsburgh, Presbyterian University Hospital, Pennsylvania 15213-2582, USA.
Am J Surg. 1998 Dec;176(6):659-65. doi: 10.1016/s0002-9610(98)00272-4.
Recent reports suggest that laparoscopic paraesophageal hernia repair (LPHR) is feasible, but no direct comparisons with the standard open paraesophageal hernia repair (OPHR) have been reported. The purpose of this study was to compare the short-term outcome of LPHR versus OPHR at a single institution.
The operative and postoperative courses of 95 consecutive patients undergoing open or laparoscopic repair of a paraesophageal hernia (PEH) were retrospectively reviewed, and outcomes of LPHR versus OPHR were compared.
PEH was associated with advanced age and significant comorbidity. Although the operative time was increased for LPHR, there was a significant reduction in blood loss, intensive care unit stay, ileus, hospital stay, and overall morbidity associated with LPHR compared with OPHR.
PEH is associated with significant comorbidity that increases the operative risk. Short-term outcomes for LPHR are superior to OPHR, suggesting that the laparoscopic approach is the preferred approach to paraesophageal hernia repair.
近期报告表明，腹腔镜食管旁疝修补术（LPHR）是可行的，但尚无与标准开放食管旁疝修补术（OPHR）的直接对比报道。本研究的目的是在单一机构比较LPHR与OPHR的短期结果。
回顾性分析95例连续接受开放或腹腔镜食管旁疝（PEH）修补术患者的手术及术后过程，并比较LPHR与OPHR的结果。
PEH与高龄和显著的合并症相关。虽然LPHR的手术时间延长，但与OPHR相比，LPHR的失血量、重症监护病房停留时间、肠梗阻、住院时间及总体发病率均显著降低。
PEH与显著的合并症相关，增加了手术风险。LPHR的短期结果优于OPHR，提示腹腔镜手术是食管旁疝修补的首选方法。
