Salminen Paulina, Ovaska Jari
Department of Surgery, Turku University Central Hospital, Kiinamyllynkatu Turku, Finland.
Surg Laparosc Endosc Percutan Tech. 2009 Oct;19(5):361-3. doi: 10.1097/SLE.0b013e3181bae1be.
Heterotopic gastric mucosal patch (HGMP) in the upper esophagus has been suggested to play a role in the pathogenesis of laryngopharyngeal reflux. The aim of this study was to evaluate the prevalence and possible clinical significance of HGMPs in patients who underwent laparoscopic Nissen fundoplication for gastroesophageal reflux disease-induced reflux laryngitis.Forty consecutive patients with pH-proven reflux laryngitis referred to surgery by a specialist in otorhinolaryngology underwent laparoscopic Nissen fundoplication between 1998 and 2002. Twenty-seven (67.5%) of these patients underwent a postoperative upper gastrointestinal endoscopy paying special attention for detecting possible HGMPs in the proximal esophagus. When HGMP was found, biopsies were taken for histologic confirmation. A small histologically confirmed HGMP was detected in 1 out of 27 patients (3.7%). The prevalence of HGMPs in the upper esophagus in this specific patient group operated on for gastroesophageal reflux disease-induced reflux laryngitis equals the reported general prevalence rates of HGMPs detected in patients referred for upper gastrointestinal endoscopy as a part of gastrointestinal tract evaluation. The role of at least small HGMPs in the proximal esophagus in the pathogenesis of laryngopharyngeal reflux is clinically insignificant.
上食管的异位胃黏膜斑（HGMP）被认为在喉咽反流的发病机制中起作用。本研究的目的是评估因胃食管反流病引起的反流性喉炎而接受腹腔镜Nissen胃底折叠术的患者中HGMP的患病率及其可能的临床意义。1998年至2002年间，40例经pH值证实为反流性喉炎并由耳鼻喉科专家转诊至外科手术的患者接受了腹腔镜Nissen胃底折叠术。其中27例（67.5%）患者术后接受了上消化道内镜检查，特别注意检测食管近端是否可能存在HGMP。发现HGMP时，取活检进行组织学确诊。27例患者中有1例（3.7%）检测到小的经组织学确诊的HGMP。在因胃食管反流病引起的反流性喉炎而接受手术的这一特定患者组中，上食管HGMP的患病率与作为胃肠道评估一部分接受上消化道内镜检查的患者中报道的HGMP总体患病率相当。食管近端至少小的HGMP在喉咽反流发病机制中的作用在临床上无显著意义。
