腹腔镜食管裂孔疝修补术后网片移入食管胃交界处;如何预防?病例报告。

Moon-Soo Lee, Dong Kyu Lee, Hyun-Young Han, Joo Heon Kim
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引用次数: 0

摘要

虽然在大型食管裂孔疝修补术中使用网片加固可以降低复发率,但也有报道称出现了各种与网片相关的并发症。一名 65 岁的妇女出现吞咽困难。患者被诊断出患有巨大食管裂孔疝,并接受了腹腔镜胃底折叠术和带网片修复的科利斯胃成形术。术后六个月,患者出现吞咽困难和呕吐。食管胃十二指肠镜检查显示网片材料移入食管胃交界处。我们对患者进行了近端胃切除术,并切除了网片。患者出院后未出现任何术后并发症。在此,我们遇到了一例罕见病例,患者在食管裂孔疝修补术后因网片引起食管胃穿孔而需要手术治疗。网片相关并发症(如侵蚀或移位)可能比之前报道的更为常见,因此应予以重视。此外,这些并发症目前在临床实践中也很常见。关于网片的应用,应仔细观察网片相关并发症的症状,如吞咽困难,以便及早发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mesh migration into esophagogastric junction after laparoscopic hiatal hernia repair; how to prevent it? A case report.

Although the use of mesh reinforcement during large hiatal hernia repair may reduce the rate of recurrence, various mesh-related complications have been reported. A 65-year-old woman presented with dysphagia. The patient was diagnosed with a large hiatal hernia and treated with laparoscopic fundoplication and Collis gastroplasty with mesh repair. Six months after surgery, the patient presented with dysphagia and vomiting. Esophagogastroduodenoscopy showed migration of mesh material into the esophagogastric junction. We performed a proximal gastrectomy with mesh removal. The patient was discharged without any postoperative complications. Herein, we encountered a rare case requiring surgical treatment to resolve mesh-induced esophagogastric perforation after hiatal hernia repair. Mesh-associated complications, such as erosion or migration, should be considered as they may be more common than previously reported. Additionally, these complications are currently underscored in clinical practice. Regarding mesh applications, symptoms of mesh-related complications, such as dysphagia, should be carefully monitored for early detection.

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