Barnes William E, Hoddinott Kevin M, Mundy Stephanie, Williams Madeline
Livingston Hospital and Healthcare Services, Inc, Salem, KY, USA.
Surg Innov. 2011 Jun;18(2):119-29. doi: 10.1177/1553350610392067. Epub 2011 Feb 8.
This retrospective study evaluated clinical outcomes in 124 consecutive gastroesophageal reflux disease (GERD) patients who underwent transoral incisionless fundoplication (TIF) at 2 community hospitals. Out of 123 patients treated successfully, 110 gave consent (74% female, median age 60 [range 21-87] years, body mass index 27.5 [19.0-47.9]). At a median 7-month follow-up (range 5-17), typical and atypical symptom scores were normalized in 75% to 80% of patients, proton pump inhibitors (PPIs) were completely discontinued by 93%, and 83% were satisfied with their current health condition. Endoscopy in 53 patients revealed Hill grade I tight valves in 89% of the cases, reduced hiatal hernia in 33/34 (97%), and healed reflux esophagitis in 25/30 (83%). Based on global analysis, 72% of the patients were in remission, 20% improved symptomatically, and only 8% had ongoing GERD. These results supported the safety and efficacy of TIF as well as encouraged its application as an alternative treatment of GERD refractory to PPIs.
这项回顾性研究评估了在两家社区医院接受经口无切口胃底折叠术（TIF）的124例连续性胃食管反流病（GERD）患者的临床结局。在123例治疗成功的患者中，110例给予了同意（女性占74%，年龄中位数为60岁[范围21 - 87岁]，体重指数为27.5[19.0 - 47.9]）。在中位7个月的随访期（范围5 - 17个月），75%至80%的患者典型和非典型症状评分恢复正常，93%的患者完全停用了质子泵抑制剂（PPI），83%的患者对其当前健康状况感到满意。53例患者的内镜检查显示，89%的病例中希尔分级为I级紧密瓣膜，34例中有33例（97%）食管裂孔疝减小，30例中有25例（83%）反流性食管炎愈合。基于整体分析，72%的患者病情缓解，20%的患者症状改善，只有8%的患者仍患有GERD。这些结果支持了TIF的安全性和有效性，并鼓励将其作为对PPI治疗无效的GERD的替代治疗方法应用。
