Winslow E R, Clouse R E, Desai K M, Frisella P, Gunsberger T, Soper N J, Klingensmith M E
Department of Surgery, Washington University School of Medicine, 660 South Euclid, WUMS Box 8109, St. Louis, MO 63110, USA.
Surg Endosc. 2003 May;17(5):738-45. doi: 10.1007/s00464-002-8538-y. Epub 2003 Mar 7.
The clinical outcomes of laparoscopic antireflux surgery (LARS) in patients with the spectrum of nonspecific spastic esophageal motor disorders (NSSDs) are not known.
From a prospective database of patients undergoing LARS between 1997 and 2000, those with preoperative manometry at our institution and follow-up at ?6 months were identified.
Of the 121 patients, 35 had NSSDs. There were no differences in symptoms between groups preoperatively, but in the immediate postoperative period NSSD patients had more symptoms than nonspastic patients. At 18-month mean follow-up, NSSD patients reported significantly more heartburn (22% vs 7%), waterbrash (14% vs 4%), and medication usage (17% vs 5%) than nonspastic patients (p <0.05 for each). Despite this difference, nearly all patients reported subjective improvement postoperatively, and the degree of improvement was similar between groups.
Patients with NSSDs are more likely to have esophageal symptoms following LARS than subjects without these abnormalities. However, these patients still experience significant improvement in preoperative symptoms.
非特异性痉挛性食管运动障碍（NSSDs）患者接受腹腔镜抗反流手术（LARS）的临床结果尚不清楚。
从1997年至2000年间接受LARS手术的患者前瞻性数据库中，识别出在我们机构进行术前测压并随访6个月的患者。
121例患者中，35例患有NSSDs。术前两组症状无差异，但术后即刻NSSD患者比非痉挛性患者症状更多。平均随访18个月时，NSSD患者报告的烧心（22%对7%）、反酸（14%对4%）和药物使用（17%对5%）显著多于非痉挛性患者（每项p<0.05）。尽管存在这种差异，但几乎所有患者术后主观症状均有改善，且两组改善程度相似。
与无这些异常的患者相比，NSSDs患者在接受LARS后更易出现食管症状。然而，这些患者术前症状仍有显著改善。
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