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腹腔镜胃底折叠术治疗胃食管反流病术后长期生活质量评估。

Evaluation of postoperative long-term quality of life after laparoscopic anterior partial fundoplication in the treatment of gastroesophageal reflux disease.

机构信息

Department of General, Visceral, Vascular and Thoracic Surgery, University of Medicine Berlin, Charité Campus Mitte, Berlin, Germany.

出版信息

Dig Surg. 2009;26(5):413-7. doi: 10.1159/000235959. Epub 2009 Feb 18.

Abstract

BACKGROUND

In the treatment of gastroesophageal reflux disease (GERD), anterior fundoplications are emphasized for their lower risk of complications compared to the posterior approach.

AIM

The aim of this study was to evaluate the long-term results of laparoscopic anterior 180 degrees fundoplication in consideration of quality of life and reflux control.

METHODS

One hundred and twenty-four patients suffering from GERD underwent laparoscopic anterior 180 degrees fundoplication and were enrolled in this observational trial. After a mean follow-up of 52 months, 95 patients remained in the study. The success of reflux control and the quality of life were assessed using standardized questionnaires (Gastrointestinal Quality of Life Index and Reflux Activity Index scores).

RESULTS

Seventy-one patients (75%) reported that the operation was fully successful. Three patients (2%) had no clear opinion, while 21 patients (22%) reported they were poorly or not satisfied. Statistical evaluation of the questionnaires showed a clear difference (p < 0.001) in quality of life scores of patients who needed a continuous postoperative treatment for GERD compared to completely satisfied patients.

CONCLUSION

The laparoscopic anterior 180 degrees partial fundoplication for the treatment of GERD can result in satisfying reflux control in long-term outcome, but the postoperative quality of life is severely affected by the success of the treatment.

摘要

背景

在胃食管反流病(GERD)的治疗中,前侧胃底折叠术因其并发症风险较低而优于后侧入路。

目的

本研究旨在评估腹腔镜前路 180 度胃底折叠术治疗胃食管反流病的长期疗效,特别是考虑生活质量和反流控制。

方法

124 例 GERD 患者接受腹腔镜前路 180 度胃底折叠术,并纳入本观察性试验。平均随访 52 个月后,95 例患者仍在研究中。采用标准化问卷(胃肠道生活质量指数和反流活动指数评分)评估反流控制和生活质量的成功率。

结果

71 例(75%)患者报告手术完全成功。3 例(2%)患者无明确意见,21 例(22%)患者报告不满意或不满意。问卷的统计学评估显示,需要持续术后治疗的 GERD 患者与完全满意的患者相比,生活质量评分存在明显差异(p<0.001)。

结论

腹腔镜前路 180 度胃底折叠术治疗胃食管反流病可长期获得满意的反流控制,但术后生活质量严重受治疗效果影响。

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