hiatal hernia repair

The incidence of hiatal hernia is higher, more common in middle-aged and elderly patients, but not necessarily all symptoms. If the symptoms are mild, medication can be used to relieve the symptoms. Only those who have obvious symptoms and the medical treatment can not be effective are suitable for surgical treatment. 1. Due to gastric acid reflux, it stimulates the lower part of the esophagus, causing esophagitis, causing burning pain or discomfort in the upper abdomen, heart socket, bloating, acid reflux, belching and other gradual aggravation. 2. Inflammation and ulceration occur in the lower part of the esophagus, resulting in hematemesis, tar, and anemia. 3. Due to esophagitis, esophageal scarring is formed for a long time, resulting in difficulty in swallowing. Treatment of diseases: esophageal hiatus hernia esophageal hiatus hernia Indication The incidence of hiatal hernia is higher, more common in middle-aged and elderly patients, but not necessarily all symptoms. If the symptoms are mild, medication can be used to relieve the symptoms. Only those who have obvious symptoms and the medical treatment can not be effective are suitable for surgical treatment. 1. Due to gastric acid reflux, it stimulates the lower part of the esophagus, causing esophagitis, causing burning pain or discomfort in the upper abdomen, heart socket, bloating, acid reflux, belching and other gradual aggravation. 2. Inflammation and ulceration occur in the lower part of the esophagus, resulting in hematemesis, tar, and anemia. 3. Due to esophagitis, esophageal scarring is formed for a long time, resulting in difficulty in swallowing. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation 1. Correct dehydration and electrolyte imbalance. 2. Correct anemia and low plasma protein, preoperative hemoglobin is not less than 10g / l is appropriate. 3. Acidic, hernia, severe burning of the sternum, preoperative application of acid-based drugs to relieve symptoms. 4. Patients with constipation should be given laxative drugs. Surgical procedure 1. Position, incision: right lateral position, left posterior lateral incision (see pleural fibrectomy), through the 7th or 8th intercostal space into the chest. 2. Expose the lower end of the esophagus: cut the left lower lung ligament, longitudinally cut the mediastinal pleura, separate the lower end of the esophagus and bypass a gauze band, carefully explore the situation of the gastric fistula and the size of the esophageal hiatus. 3. Retraction: Cut the peritoneum and the esophageal ligament around the esophagus, leaving the residual edge about 2cm around the door, and the cardia and corpus to be included in the abdominal cavity. At the posterior edge of the esophagus, a needle is placed on the right temporal muscle to define a puncture for the subsequent suture. 4. Fixation: The residual edge of the peritoneal ligament that will remain in the cardia is sutured around the diaphragmatic esophageal hiatus with suture thread. 5. Reconstruction of esophageal hiatus: After the fixed suture suture is ligated, the iliac crest is sutured at the posterior end of the esophagus, usually 2 to 3 needles. 6. Close the chest: suture the incision of the mediastinal pleura, place the closed thoracic drainage, and close the chest layer by layer. complication Stomach acid.