外科理论与实践

外科理论与实践 >

2026 , Vol. 31 >Issue 01: 45 - 49

DOI: https://doi.org/10.16139/j.1007-9610.2026.01.08

论著

腹腔镜疝修补术治疗食管裂孔疝合并缺铁性贫血的临床疗效分析

  • 麦麦提艾力·麦麦提明 ,
  • 多力坤·牙生 ,
  • 黄卓 ,
  • 黄旭东 ,
  • 艾克拜尔·艾力 ,
  • 克力木·阿不都热依木
展开
  • 新疆维吾尔自治区人民医院微创、疝和腹壁外科， 新疆胃食管反流病与减重代谢外科临床医学研究中心，新疆普外微创研究所， 新疆 乌鲁木齐 830001
作者贡献/Authors’ contributions

麦麦提艾力·麦麦提明负责研究设计、资料收集、数据分析和论文撰写；多力坤·牙生、黄卓、黄旭东负责数据整理和文献查阅；艾克拜尔·艾力负责手术实施和指导；克力木·阿不都热依木负责研究指导、论文审阅和修改。所有作者均阅读并同意最终稿。

克力木·阿不都热依木，E-mail: klm6075@163.com

收稿日期: 2025-11-20

  网络出版日期: 2026-04-21

收起

Clinical efficacy analysis of laparoscopic hernia repair in treating hiatal hernia with iron-deficiency anemia

  • MAIMAITIAILI Maimaitiming ,
  • DUOLIKUN Yasheng ,
  • HUANG Zhuo ,
  • HUANG Xudong ,
  • AIKEBAIER Aili ,
  • KELIMU Abudureyimu
Expand
  • Department of Minimally Invasive, Hernia and Abdominal Wall Surgery, Xinjiang Uygur Autonomous Region People’s Hospital, Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric & Metabolic Surgery, Xinjiang Institute of General and Minimally Invasive Surgery, Xinjiang Urumqi 830001, China

Received date: 2025-11-20

  Online published: 2026-04-21

Fold

摘要

目的：探讨腹腔镜食管裂孔疝修补术(LHHR)治疗合并缺铁性贫血(IDA)的食管裂孔疝(HH)病人的临床疗效。方法：回顾性分析2012年1月至2024年12月本院收治的195例HH合并IDA病人的临床资料。所有病人均接受(LHHR)，比较其术前（入院时）与术后12个月的血红蛋白(Hb)水平、贫血症状改善情况及胃食管反流病问卷（GERD-Q）评分。结果：195例中，女性129例（66.2%），巨大型HH 80例（41.0%）。18~40岁13例（6.7%），41~60岁78例（40.0%），≥60岁104例（53.3%）。术后12个月随访显示，Hb水平由术前的（108.4±12.6）g/L显著上升至（128.7±11.3）g/L（P<0.001），所有病人贫血症状均消失；GERD-Q评分由（11.2±2.1）分降至（7.0±1.5）分（P<0.001）。影像学复查未见HH复发。结论：LHHR可有效纠正IDA，改善反流症状，短期疗效显著且安全。长期疗效仍需进一步随访评估。

关键词： 食管裂孔疝; 缺铁性贫血; 腹腔镜修补术

本文引用格式

麦麦提艾力·麦麦提明 , 多力坤·牙生 , 黄卓 , 黄旭东 , 艾克拜尔·艾力 , 克力木·阿不都热依木 . 腹腔镜疝修补术治疗食管裂孔疝合并缺铁性贫血的临床疗效分析[J]. 外科理论与实践, 2026 , 31(01) : 45 -49 . DOI: 10.16139/j.1007-9610.2026.01.08

Abstract

Objective To investigate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) in patients with hiatal hernia (HH) complicated by iron-deficiency anemia (IDA). Methods A retrospective analysis was conducted on 195 HH patients with IDA who underwent LHHR at our hospital from January 2012 to December 2024. Preoperative and 12 months postoperative hemoglobin (Hb) levels, anemia-related symptoms, and Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scores were compared. Results Among the 195 patients, 129 (66.2%) were female, and 80 (41.0%) had massive HH. There were 13 patients (6.7%) aged 18-40 years, 78 (40.0%) aged 41-60 years, and 104 (53.3%) over 60 years. At 12 months follow-up, Hb levels significantly increased from (108.4±12.6) g/L to (128.7±11.3) g/L (P<0.001), with resolution of anemia symptoms in all patients. GERD-Q scores decreased from (11.2±2.1) to (7.0±1.5) (P<0.001). No recurrence of HH was observed on imaging. Conclusions LHHR is effective in correcting IDA and alleviating reflux symptoms, demonstrating favorable short-term outcomes and safety. Long-term efficacy warrants further follow-up evaluation.

Key words： Hiatal hernia(HH); Iron-deficiency anemia(IDA); Laparoscopic repair

参考文献

[1] ANDOLFI C, JALILVAND A, PLANA A, et al. Surgical treatment of paraesophageal hernias: a review[J]. J Laparoendosc Adv Surg Tech A, 2016, 26(10):778-783.
[2] 中国医师协会外科医师分会胃食管反流病专业委员会. 成人胃食管反流病外科诊疗共识(2025版)[J]. 中华胃食管反流病电子杂志, 2025, 12(1):1-9.
  Gastroesophagea Reflux Disease Professional Committee, Chinese College of Surgeons. Consensus on diagnosis and surgical treatment of adult gastroesophageal reflux disease (2025 edition)[J]. Chin J Gastro Reflux Dis(Electronic Edition), 2025, 12(1):1-9.
[3] WINDSOR C W, COLLIS J L. Anaemia and hiatus hernia: experience in 450 patients[J]. Thorax, 1967, 22(1):73-78.
[4] HAURANI C, CARLIN A M, HAMMOUD Z T, et al. Prevalence and resolution of anemia with paraesophageal hernia repair[J]. J Gastrointest Surg, 2012, 16(10):1817-1820.
[5] BULDANLI M Z, U?ANER B, ?IFT?I M S, et al. Laparoscopic Nissen fundoplication: a five-year single-center clinical experience and results[J]. Eur Rev Med Pharmacol Sci, 2023, 27(4):1346-1351.
[6] PLYMALE M A, JOHNSON C E, TENNANT S L, et al. Resolution and recurrence of anemia following repair of paraesophageal hernias[J]. Surg Endosc, 2023, 37(11): 8708-8713.
[7] PIERRE A F, LUKETICH J D, FERNANDO H C, et al. Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients[J]. Ann Thorac Surg, 2003, 74(4):1909-1915.
[8] MITIEK M O, ANDRADE R S. Giant Hiatal Hernia[J]. Ann Thorac Surg, 2010, 89(6):S2168-S2173.
[9] CHINN J O, RUHI-WILLIAMS P, SHACKER M, et al. Mild to moderate GERD before sleeve: can we better predict post-operative GERD?[J]. Surg Endosc, 2025, 39(10):6934-6942.
[10] CAMERON A J, HIGGINS J A. Linear gastric erosion. A lesion associated with large diaphragmatic hernia and chronic blood loss anemia[J]. Gastroenterology, 1986, 91(2):338-342.
[11] AILI A, MAIMAITIMING M, LI Y, et al. Laparoscopic hiatal hernia repair for treating patients with massive hiatal hernia and iron-deficiency anaemia[J]. BMC Surg, 2023, 23(1):293.
[12] PANZUTO F, DI GIULIO E, CAPURSO G, et al. Large hiatal hernia in patients with iron deficiency anaemia: a prospective study on prevalence and treatment[J]. Aliment Pharmacol Ther, 2004, 19(6):663-670.
[13] DALY S, KUMAR S S, COLLINGS A T, et al. SAGES guidelines for the surgical treatment of hiatal hernias[J]. Surg Endosc, 2024, 38(9):4765-4775.
[14] CARROTT P W, MARKAR S R, HONG J, et al. Iron-deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair[J]. J Gastrointest Surg, 2013, 17(5):858-862.
[15] 阿卜杜萨拉木·阿卜杜合力力, 克力木·阿不都热依木. 巨大食管裂孔疝与缺铁性贫血发生相关性研究新进展[J]. 中华胃食管反流病电子杂志, 2019, 6(4):222-225.
  ABUDUHELILI A, ABUDUREYIMU K. New progress in the study of the relationship between massive hiatal hernia and iron deficiency anemia[J]. Chin J Gastro Reflux Dis (Electronic Edition), 2019, 6(4):222-225.
Options
文章导航

/

〈 〉