Anvari Mehran, Allen Christopher, Marshall John, Armstrong David, Goeree Ron, Ungar Wendy, Goldsmith Charles
Centre for Minimal Access Surgery, Department of Surgery, St Joseph's Healthcare, 50 Charlton Ave E, Hamilton, ON, L8N 4A6 Canada.
Surg Innov. 2006 Dec;13(4):238-49. doi: 10.1177/1553350606296389.
A randomized controlled trial conducted in patients with gastroesophageal reflux disease compared optimized medical therapy using proton pump inhibitor (n = 52) with laparoscopic Nissen fundoplication (n = 52). Patients were monitored for 1 year. The primary end point was frequency of gastroesophageal reflux dis-ease symptoms. Surgical patients had improved symptoms, pH control, and overall quality of life health index after surgery at 1 year compared with the medical group. The overall gastroesophageal reflux disease symptom score at 1 year was unchanged in the medical patients, but improved in the surgical patients. Fourteen patients in the medical arm experienced symptom relapse requiring titration of the proton pump inhibitor dose, but 6 had satisfactory symptom remission. No surgical patients required additional treatment for symptom control. Patients controlled on long-term proton pump inhibitor therapy for chronic gastroesophageal reflux disease are excellent surgical candidates and should experience improved symptom control after surgery at 1 year.
一项针对胃食管反流病患者进行的随机对照试验，将使用质子泵抑制剂的优化药物治疗（n = 52）与腹腔镜Nissen胃底折叠术（n = 52）进行了比较。对患者进行了1年的监测。主要终点是胃食管反流病症状的频率。与药物治疗组相比，手术患者在术后1年时症状得到改善，pH值得到控制，总体生活质量健康指数也有所提高。药物治疗组患者1年时的总体胃食管反流病症状评分没有变化，但手术患者的症状评分有所改善。药物治疗组有14名患者症状复发，需要调整质子泵抑制剂的剂量，但有6名患者症状得到了满意的缓解。没有手术患者需要额外治疗来控制症状。长期使用质子泵抑制剂治疗慢性胃食管反流病且症状得到控制的患者是优秀的手术候选者，术后1年症状控制应会得到改善。
