Beldi Guido, Gláttli Andreas
Department of Surgery, Zieglerspital, Bern, Switzerland.
Surg Laparosc Endosc Percutan Tech. 2002 Oct;12(5):316-9. doi: 10.1097/00129689-200210000-00002.
Patients who have undergone fundoplication may be at risk for recurrent gastroesophageal reflux and may experience postoperative gastrointestinal symptoms. We investigated the long-term symptomatic outcome after laparoscopic Nissen fundoplication. Between 1993 and 1998 we treated 60 patients with laparoscopic fundoplication for gastroesophageal reflux disease. Signs of recurrence and gastrointestinal symptoms were assessed in 55 (92%) patients after a minimum follow-up of 1 year (median: 3.6 years). At follow-up, 52 patients (95%) were completely free of reflux symptoms. Mild gastrointestinal symptoms (flatulence, 60%; early satiety, 51%; meteorism, 42%; inability to vomit, 27%; dysphagia, 25%; diarrhea, 25%; epigastric pain, 24%; inability to belch, 22%) were found in a total of 51 patients (93%). Disturbing symptoms occurred in only 9 patients (16%). Laparoscopic Nissen fundoplication results in excellent control of gastroesophageal reflux disease at long-term follow-up. Despite a high rate of gastrointestinal symptoms, patient satisfaction showed the operation to be effective and well tolerated.
接受过胃底折叠术的患者可能有胃食管反流复发的风险，并且可能会出现术后胃肠道症状。我们研究了腹腔镜Nissen胃底折叠术后的长期症状转归。1993年至1998年期间，我们对60例胃食管反流病患者进行了腹腔镜胃底折叠术治疗。在至少随访1年（中位数：3.6年）后，对55例（92%）患者评估了复发迹象和胃肠道症状。随访时，52例（95%）患者完全没有反流症状。共有51例（93%）患者出现轻度胃肠道症状（腹胀，60%；早饱，51%；胃肠胀气，42%；无法呕吐，27%；吞咽困难，25%；腹泻，25%；上腹部疼痛，24%；无法嗳气，22%）。只有9例（16%）患者出现令人困扰的症状。腹腔镜Nissen胃底折叠术在长期随访中能很好地控制胃食管反流病。尽管胃肠道症状发生率较高，但患者满意度表明该手术有效且耐受性良好。
