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首页> 外文期刊>Surgical Endoscopy >Outcomes of surgical management of symptomatic large recurrent hiatus hernia
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Outcomes of surgical management of symptomatic large recurrent hiatus hernia

机译：有症状的大复发性裂孔疝的外科治疗结果

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Objective Recurrent hiatus hernia is frequently found in patients undergoing reoperative antireflux surgery. The objective of this study is to report perioperative complications and subjective and objective outcomes for patients who underwent reoperative intervention for symptomatic large recurrent hiatus hernia. Methods Retrospective review of a prospectively maintained database was performed to identify patients with large (C5 cm gastric tissue above the crus) recurrent hiatus hernia who underwent reoperation after failed antireflux surgery. Data for preoperative workup, operative procedure, and postoperative 6-month follow-up were reviewed and analyzed. Results Two hundred twenty patients underwent reoperation over a 6-year period. Forty-four patients had large recurrent hiatus hernia; 21 underwent redo fundoplication, while 23 underwent Roux-en-Y (RNY) reconstruction as remedial procedure. Short esophagus was found in 16 cases (6 of 21 redo Collis fundoplications, 10 of 23 RNY reconstructions). There was significant symptom improvement and high degree of satisfaction reported in both groups. However, patients with short esophagus did better with RNY reconstruction compared with redo Collis gastroplasty. Conclusions Repair of large recurrent hiatus hernia is a technically challenging procedure; however, there is high degree of symptom resolution and patient satisfaction. RNY reconstruction might be a better alternative in patients with short esophagus compared with redo Collis gastroplasty.
机译：目的复发性食管裂孔疝常发生在接受抗反流手术的患者中。这项研究的目的是报告对有症状的大复发性裂孔疝进行手术治疗的患者的围手术期并发症以及主观和客观结果。方法对前瞻性维护的数据库进行回顾性回顾，以鉴定患有较大（在结节上方C5 cm胃组织）复发性裂孔疝的患者，这些患者在抗反流手术失败后接受了再次手术。回顾并分析了术前检查，手术步骤和术后6个月随访的数据。结果620名患者在6年的时间里接受了再次手术。四十四例患者出现较大的复发性裂孔疝。 21例接受了重做胃底折叠术，而23例接受了Roux-en-Y（RNY）重建作为补救措施。在16例患者中发现了短食管（21例重度Collis胃底折叠术中有6例，RNY重建术中有10例）。两组均有明显的症状改善和高度满意度。然而，与重做Collis胃成形术相比，食管短的患者通过RNY重建的效果更好。结论修复大面积复发性裂孔疝是一项技术难题。但是，症状缓解和患者满意度很高。与重做Collis胃成形术相比，RNY重建对于食管短的患者可能是更好的选择。

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