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首页> 外文期刊>Surgical Endoscopy >Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation.
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Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation.

机译：最初在腹腔镜可调胃带手术中进行的裂孔疝修补术减少了再次手术的需要。

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BACKGROUND: Intractable reflux, either due to gastric prolapse or concentric pouch dilatation has been the most common indication for reoperation or band removal after laparoscopic adjustable gastric banding (LAGB). We have previously found that a simple hiatal hernia repair (HHR) leads to remission of these symptoms minimizing the need for band removal. We have subsequently added crural repair/HHR at the initial operation, where indicated. In this study compare the rate of reoperation in patients who underwent LAGB alone, or with concurrent HHR. METHODS: A retrospective review of a prospective database of all patients undergoing LAGB was performed to determine the incidence of reoperation in the two groups. RESULTS: Between July 2001 and August of 2006, 1298 patients underwent LAGB and 520 patients underwent LAGB with concurrent HHR (LAGB/HHR). The mean initial weight and BMI were 128 kg (range, 71.1-245.7 kg) and 45.4 kg/m(2) (range, 28-75 kg/m(2)). Average follow-up for the LAGB and LAGB/HHR groups was 24.8 and 20.5 months, respectively. Rate of reoperation for HHR alone, or with band slip or concentric pouch dilatation, for LAGB and LAGB/HHR groups was 5.6% and 1.7% respectively (p < 0.001). Total reoperation rate for slip, HHR and pouch dilatation was 7.9% and 3.5%, respectively (p < 0.001). There was no significant difference in rate of slip repair alone between the two groups: 2.3% and 1.7%, respectively (p < 0.44). CONCLUSIONS: Adding HHR to LAGB where indicated significantly reduces reoperation rate. Every effort should be made to detect and repair HHR during placement of the band, as it will decrease future need for reoperation.
机译：背景：由于胃脱垂或同心囊扩张引起的顽固性返流已成为腹腔镜可调胃绑扎术（LAGB）后再次手术或去除腕带的最常见指征。我们先前已经发现，单纯的裂孔裂孔疝修补术（HHR）可以缓解这些症状，从而最大程度地减少了去除腕带的必要性。随后，在有指明的地方，我们随后在了初次手术时增加了关键修复/ HHR。在这项研究中，比较单独接受LAGB或并发HHR的患者的再手术率。方法：对所有接受LAGB的患者进行前瞻性数据库的回顾性研究，以确定两组的再次手术发生率。结果：在2001年7月至2006年8月之间，有1298例患者接受了LAGB，同时有520例患者接受了同时进行HHR（LAGB / HHR）的LAGB。平均初始体重和BMI为128千克（范围71.1-245.7千克）和45.4千克/米2（范围28-75千克/米2）。 LAGB和LAGB / HHR组的平均随访时间分别为24.8和20.5个月。 LAGB和LAGB / HHR组单独进行HHR或带滑或同心囊扩张的再手术率分别为5.6％和1.7％（p <0.001）。滑脱，HHR和囊袋扩张的总再手术率分别为7.9％和3.5％（p <0.001）。两组之间单独的滑脱修复率无显着差异：分别为2.3％和1.7％（p <0.44）。结论：在所指示的LAGB中增加HHR可显着降低再手术率。放置频段时应尽一切努力检测和修复HHR，因为这将减少将来重新操作的需要。

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