[腹腔镜抗反流手术治疗胃食管反流病：4年经验报告]

[Laparoscopic antireflux surgery for gastroesophageal reflux disease: report on a 4-year experience].

作者信息

Kleimann E, Halbfass H J

机构信息

Klinik für Allgemeinchirurgie, Städtische Kliniken Oldenburg.

出版信息

Chirurg. 1999 Apr;70(4):456-63. doi: 10.1007/s001040050672.

DOI:10.1007/s001040050672

PMID:10354846

Abstract

In a period of 4 years between March 1994 and March 1998, 143 patients with gastroesophageal reflux disease (GERD) underwent laparoscopic antireflux surgery. According to manometric studies 76 patients had a short-floppy Nissen fundoplication, patients with impaired motility or paraesophageal hernias received a hemifundoplication (Toupet = 42, Dor/Thal = 25). Recurrent reflux symptoms appeared in 6.3% after mean 16.7 months follow-up (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 24%, P < 0.01). Persistent dysphagia with reoperation occurred in 2.1% (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 0%, n.s.). The assessment of Visick's score at the latest control showed the following: Visick I = 63.6%, Visick II = 30.1%, Visick III = 6.3%, Visick IV = 0%. The outcome of the operation was rated "excellent" or "good" by 91.6% of the patients.

摘要

在1994年3月至1998年3月的4年期间，143例胃食管反流病（GERD）患者接受了腹腔镜抗反流手术。根据测压研究，76例患者进行了短松驰型Nissen胃底折叠术，动力障碍或食管旁疝患者接受了半胃底折叠术（Toupet术式=42例，Dor/Thal术式=25例）。平均随访16.7个月后，6.3%的患者出现复发性反流症状（Nissen术式=2.6%，Toupet术式=2.3%，Dor/Thal术式=24%，P<0.01）。2.1%的患者出现持续性吞咽困难并再次手术（Nissen术式=2.6%，Toupet术式=2.3%，Dor/Thal术式=0%，无显著性差异）。最近一次复查时Visick评分结果如下：Visick I级=63.6%，Visick II级=30.1%，Visick III级=6.3%，Visick IV级=0%。91.6%的患者对手术结果评为“优秀”或“良好”。