Ramacciato Giovanni, D'Angelo Francesco, Aurello Paolo, Mercantini Paolo, Fernandes Eduardo, Bellagamba Riccardo
UOC Chirurgia A, Ospedale S. Andrea, II Facoltà di Medicina e Chirurgia Università degli Studi di Roma La Sapienza.
Chir Ital. 2004 Jul-Aug;56(4):489-94.
The aim of the study was to assess laparoscopic myotomy associated with angle of His reconstruction as an antireflux procedure in the treatment of achalasia. Thirty-one patients underwent a laparoscopic Heller myotomy; in 17 cases this was combined with an anterior partial funduplication, while in 14 cases the angle of His was reconstructed as an antireflux procedure. No postoperative morbidity or mortality were recorded in either group. and no statistical significance was found between the two groups in terms of recurrent dysphagia, postoperative reflux or medical therapy. In conclusion, enhancing the angle of His as an antireflux mechanism proved as effective as partial anterior fundoplication in reducing the incidence of recurrent achalasia.
本研究的目的是评估腹腔镜下肌层切开术联合His角重建作为一种抗反流手术治疗贲门失弛缓症的效果。31例患者接受了腹腔镜Heller肌层切开术;其中17例联合了前位部分胃底折叠术,而14例患者将His角重建作为抗反流手术。两组均未记录到术后发病率或死亡率。在复发性吞咽困难、术后反流或药物治疗方面,两组之间未发现统计学差异。总之,作为一种抗反流机制,增强His角在降低复发性贲门失弛缓症的发生率方面与部分前位胃底折叠术同样有效。