초록접수 현황
| 17F-057 | 구연 미채택시 포럼 발표 |
Laparoscopic Repair of Hiatal Hernia
Ju Sik Yun¹, Kook Joo Na¹, Gwan Sic Kim², Kyo Seon Lee², Do Wan Kim², Yochun Jung², In Seok Jeong², Bong-Suk Oh², Byoung Hee Ahn², Seok Kim¹, Sang Yun Song¹
¹Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Republic of Korea., ²Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
Purpose : Laparoscopic hiatal hernia repair is a complex operation and seems to be associated with a high recurrence rates. We introduce our experience with laparoscopic repair of hiatal hernia
Methods : We performed minimally invasive esophageal surgery in esophageal cancer patients since September 2004, and began performing laparoscopic repair of hiatal hernia in January 2006. 18 consecutive patients had undergone this approach.
Results : There were 1 male and 17 female with a median age of 73 years (range, 37–81 years). Nine patients (50%) were symptomatic. Among them, 6 (75%) suffered from reflux symptoms such as heartburn. 4 patients had a history of abdominal surgery. The type of hiatal hernia was I in 3 patients, II in 9, III in 5, and IV in 1. Out of the 18 laparoscopic procedures, two required a conversion (11.1%). All the patients underwent complete hernia sac dissection, crural reapproximation, and Nissen fundoplication routinely. Modified Collis gastroplasty (esophageal lengthening procedure) was used in five patients (27.8%). The mean operation time was 213.8 ± 70.1 min (range, 120~425 min) and mean hospital stay was 6.2 ± 1.5 days (range, 4~9 days). There were no postoperative complications. At the time of last follow-up, 83.3% of patients were asymptomatic. Recurrent hiatal hernia was shown on a esophagogram in one patient at 3.5 years after laparoscopic surgery. This patient was being considered for revision surgery.
Conclusion : Laparoscopic repair of hiatal hernia is a feasible technique with a satisfactory surgical outcomes. It can be performed by thoracic surgeons experienced in the laparoscopic approach.
Methods : We performed minimally invasive esophageal surgery in esophageal cancer patients since September 2004, and began performing laparoscopic repair of hiatal hernia in January 2006. 18 consecutive patients had undergone this approach.
Results : There were 1 male and 17 female with a median age of 73 years (range, 37–81 years). Nine patients (50%) were symptomatic. Among them, 6 (75%) suffered from reflux symptoms such as heartburn. 4 patients had a history of abdominal surgery. The type of hiatal hernia was I in 3 patients, II in 9, III in 5, and IV in 1. Out of the 18 laparoscopic procedures, two required a conversion (11.1%). All the patients underwent complete hernia sac dissection, crural reapproximation, and Nissen fundoplication routinely. Modified Collis gastroplasty (esophageal lengthening procedure) was used in five patients (27.8%). The mean operation time was 213.8 ± 70.1 min (range, 120~425 min) and mean hospital stay was 6.2 ± 1.5 days (range, 4~9 days). There were no postoperative complications. At the time of last follow-up, 83.3% of patients were asymptomatic. Recurrent hiatal hernia was shown on a esophagogram in one patient at 3.5 years after laparoscopic surgery. This patient was being considered for revision surgery.
Conclusion : Laparoscopic repair of hiatal hernia is a feasible technique with a satisfactory surgical outcomes. It can be performed by thoracic surgeons experienced in the laparoscopic approach.
책임저자: Kook Joo Na
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Jeollanam-do, Republic of Korea
발표자: Ju Sik Yun, E-mail : jusikyun@gmail.com