摘要
胃扭轉是一種罕見的疾病，影響多為老年人。它的發生主要是因為先天性固定胃部韌帶鬆弛所引起。它的發生也常伴隨著橫膈缺損的情形。這有時會導致胃部疝入胸腔內而引起呼吸窘迫或疝入部分發生缺血性或壞疽的變化。這種疾病可以為急性或慢性的形式表現。我們過去十三年內曾為十六位橫膈缺損併慢性胸腔內胃扭轉的病人作腹腔鏡手術治療。所有患者均為繼發型。十二位病人屬於器官軸性胃扭轉型、四位屬於腸系膜軸性胃扭轉型。所有患者均接受非急性手術。所有患者手術後均恢復良好且無明顯併發症。患者住院時間多為五天。手術後，所有患者的胃腸道均通暢。同時，所有患者經該次身體異常矯正手術後其肺功能均有改善。儘管在全球以腹腔鏡手術治療橫膈缺損併慢性胸腔內胃扭轉的經驗有限，但是由我們的結果看來以腹腔鏡技術來處理該疾病似乎是安全和可行的。
關鍵詞：橫膈缺損，慢性胸腔內胃扭轉，腹腔鏡手術
Abstract
Gastric volvulus is an uncommon disease condition that affects mostly the elderly. It occurs mainly as a result of congenital laxity of ligament attachments of the stomach. It is also accompanied by a diaphragmatic hernia. This sometimes causes the stomach herniation into the thorax, giving rise to respiratory compromise, herniated part ischemic or gangrenous change. This disease could present as acute or chronic condition. We have managed 16 patients with diaphragmatic hernia and chronic intra-thoracic gastric volvulus under laparoscopy over the past thirteen years; all patients are of secondary type. Twelve (12) patients belong to organoaxial type and four (4) were mesenteroaxial type. Elective surgery was performed for all these patients. All patients recovered well from surgery without evident complications. Most of their hospital stays were five days. After operation, patent gastrointestinal tract was noted in all patients. Besides, all patients showed improvement of pulmonary condition after surgical correction of anatomic anomaly. Even though worldwide experience in laparoscopic surgery for diaphragmatic hernia and chronic intra-thoracic gastric volvulus is limited, our results are encouraging. Based on our experience, laparoscopic technique seems to be safe and feasible in treatment of this disease.
Keywords: Diaphragmatic Hernia, Chronic Intra-Thoracic Gastric Volvulus, Laparoscopic Surgery