Salminen P
Department of Surgery, Turku University Central Hospital, Turku, Finland.
Surgeon. 2009 Aug;7(4):224-7. doi: 10.1016/s1479-666x(09)80089-9.
Laparoscopic Nissen fundoplication has become the method of choice in antireflux surgery replacing its open counterpart before the long-term results of controlled clinical trials were available. METHODS AND AIM: Review of the literature to highlight the long-term results of laparoscopic Nissen fundoplication.
Long-term symptom relief regarding significant reflux symptoms of heartburn and regurgitation can be achieved by laparoscopic fundoplication in 84% to 97% and patients' overall satisfaction with the result of their laparoscopic fundoplication surgery is high, ranging from 86% to 96%. The long-term results of randomised trials have shown no statistically significant differences in subjective symptomatic outcome between laparoscopic and open Nissen fundoplication. Complaints regarding the scar, incisional hernias and higher incidence of defective wraps were associated with the open approach.
At long-term follow-up the laparoscopic Nissen fundoplication has a similar long-term subjective symptomatic outcome as the open procedure but laparoscopic Nissen fundoplication is associated with a significantly lower incidence of incisional hernias and defective fundic wraps at endoscopy, defining laparoscopic Nissen fundoplication as the procedure of choice in surgical management of gastro-oesophageal reflux disease.
在对照临床试验的长期结果出来之前，腹腔镜下尼氏胃底折叠术已成为抗反流手术的首选方法，取代了开放手术。
回顾文献以突出腹腔镜下尼氏胃底折叠术的长期结果。
腹腔镜胃底折叠术可使84%至97%的患者烧心和反流等明显反流症状得到长期缓解，患者对腹腔镜胃底折叠术手术结果的总体满意度较高，在86%至96%之间。随机试验的长期结果显示，腹腔镜下和开放的尼氏胃底折叠术在主观症状结果方面无统计学显著差异。与开放手术相关的问题包括对瘢痕的抱怨、切口疝以及胃底折叠不良发生率较高。
长期随访显示，腹腔镜下尼氏胃底折叠术与开放手术在长期主观症状结果方面相似，但腹腔镜下尼氏胃底折叠术在内镜检查时切口疝和胃底折叠不良的发生率显著更低，这使得腹腔镜下尼氏胃底折叠术成为胃食管反流病手术治疗的首选方法。
