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首页> 外文期刊>Surgical Endoscopy >Do recurrences after paraesophageal hernia repair matter? : Ten-year follow-up after laparoscopic repair.
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Do recurrences after paraesophageal hernia repair matter? : Ten-year follow-up after laparoscopic repair.

机译：食管旁疝修补术后的复发重要吗？ ：腹腔镜手术后十年随访。

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摘要

BACKGROUND: The recurrence rate for paraesophageal hernias (PEH) can be as high as 30% following laparoscopic repair. The aim of this study was to determine the severity of symptoms in patients with recurrences and the need for reoperation 10 years after surgery. METHODS AND PROCEDURES: Consecutive laparoscopic paraesophageal cases performed at a single institution between 1993 and 1996 were identified from the institution's foregut database. Patients were asked about the presence and severity of symptoms (heartburn, chest pain, regurgitation, and dysphagia). Patients were also asked whether they had (1) been diagnosed with hernia recurrence or (2) undergone repeat surgical intervention. RESULTS: Complete follow-up was obtainable in 31 of the total of 52 patients (60%). The proportion of patients reporting moderate/severe symptoms was less at 10 years than preoperatively: heartburn 12% versus 54% (p < 0.001), chest pain 9% versus 36% (p = 0.01), regurgitation 6% versus 50% (p < 0.001), and dysphagia 3%versus 30% (p = 0.001). Two patients underwent repeat surgical intervention for symptomatic recurrences within the first postoperative year. Eight more patients have been diagnosed with hernia recurrences on either contrast esophagram or upper endoscopy but had not required reoperation. At ten years, more patients with hernia recurrence had heartburn than those who did not have recurrences (60% versus 14%; p < 0.05). CONCLUSIONS: Despite a hiatal hernia recurrence rate of 32% 10 years after surgery, laparoscopic PEH was a successful procedure in the majority of patients; most remained symptomatically improved and required no further intervention 10 years after surgery.
机译：背景：腹腔镜修复后食管旁疝（PEH）的复发率可高达30％。本研究的目的是确定复发患者的症状严重程度以及术后10年是否需要再次手术。方法和程序：从该机构的前肠数据库中识别出1993年至1996年间在同一机构进行的连续腹腔镜食管食管病例。询问患者症状的存在和严重程度（烧心​​，胸痛，反流和吞咽困难）。还询问患者是否（1）被诊断患有疝气复发或（2）重复进行外科手术干预。结果：52例患者中有31例（60％）获得了完整的随访。在10年内，报告中度/重度症状的患者比例低于术前：胃灼热12％对54％（p <0.001），胸痛9％对36％（p = 0.01），反流6％对50％（p <0.001）和吞咽困难3％对30％（p = 0.001）。两名患者在术后第一年内因症状复发而再次接受外科手术干预。对比食管造影或上内镜检查已确诊另外八例疝气复发，但无需再次手术。十年后，疝复发的胃癌患者比未复发的患者多（60％比14％; p <0.05）。结论：尽管术后10年裂孔疝复发率达到32％，但腹腔镜PEH在大多数患者中是成功的手术方法。大多数患者的症状仍得到改善，并且术后10年无需进一步干预。

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