ABSTRACT
With the great improvement of living and material conditions in China, obesity concomitant with hernia and abdominal wall diseases become very common. As the particularities of obesity and associated metabolic diseases, a series of pathophysiological changes caused by obesity will significantly affect the treatment of hernia and abdominal wall diseases. In the authors' opinions, accurately evaluation the severity of obesity and associated metabolic diseases and effec-tively controlling are important prerequisites for determining the timing of surgery and surgical planning. Weight loss before surgery is the basic principle of the treatment and immediate or staged individualized surgical treatment is the guarantee of the successful treatment for obesity patients with hernia and abdominal wall disease.
ABSTRACT
Objective To explore the feasibility of laparoscopic surgery for esophageal hiatus hernia and reflux esophagitis complicated with cholecystolithiasis.Methods Five trocars were used for the patients to perform laparoscopic hiatal hernia repair,followed by fundoplication(Nissen fundoplication in 21 cases and Toupet fundoplication in 6),and then LC.Results The procedures were completed in all of the 27 cases.The postoperative mean esophageal pressure of the patients was significantly higher than that before the operations [(19.32?4.11) mm Hg vs(7.30?1.36) mm Hg,t=-16.407,P=0.000],while the 24-hour pH value were decreased markedly(9.20?2.15 vs 160.16?50.30,t=16.387,P=0.000).No hemorrhage,intra-abdominal infection,biliary leakage occurred in this series.The patients were followed up for 1 to 24 months(1-6 months in 7 cases,and 7-24 months in 20 cases),during which no esophageal stenosis or incisional hernia were detected.Conclusions It is feasible to perform primary laparoscopic surgery for patients suffering from esophageal hiatus hernia and reflux esophagitis complicated with simultaneous cholecystolithiasis,if no contraindications.