Terry Maria L, Vernon Ashley, Hunter John G
Department of Surgery, University of New Mexico, 915 Camino de Salud NE, 2ACC, Albuquerque, NM, USA.
Am J Surg. 2004 Aug;188(2):195-9. doi: 10.1016/j.amjsurg.2003.12.069.
Minimally invasive Collis gastroplasty is an established technique for managing the shortened esophagus. The purpose of this report is to describe our new technique, the wedge gastroplasty, and report the short-term outcomes.
All patients (n = 143) undergoing laparoscopic fundoplication from May 2000 to March 2001 were assessed intraoperatively for shortened esophagus. After mediastinal dissection, 15 patients with inadequate intraabdominal esophageal length underwent wedge gastroplasty. Preoperative symptoms, operative times, and short-term outcomes were evaluated.
Mean operative time was 184 +/- 36 minutes (range 138 to 258). There was 1 cervical esophageal tear from bougie passage and no other minor or major complications. At 6 weeks, there was more improvement in esophageal symptoms compared with extraesophageal symptoms.
Wedge gastroplasty is effective in decreasing symptoms in patients with shortened esophagus and takes less time to perform than other gastroplasty techniques. Further study is needed to assess long-term outcomes.
微创科利斯胃成形术是治疗食管缩短的一种成熟技术。本报告的目的是描述我们的新技术——楔形胃成形术，并报告其短期疗效。
对2000年5月至2001年3月期间接受腹腔镜胃底折叠术的所有患者（n = 143）在术中评估食管是否缩短。纵隔解剖后，15例腹段食管长度不足的患者接受了楔形胃成形术。对术前症状、手术时间和短期疗效进行了评估。
平均手术时间为184±36分钟（范围138至258分钟）。探条通过时发生1例颈段食管撕裂，无其他轻微或严重并发症。6周时，食管症状的改善比食管外症状更明显。
楔形胃成形术可有效减轻食管缩短患者的症状，且与其他胃成形术技术相比，手术时间更短。需要进一步研究以评估长期疗效。
