Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Academic Surgical Unit, 10th Floor, QEQM Building, South Wharf Rd., London, W2 1NY UK.
Am J Surg. 2011 Sep;202(3):336-43. doi: 10.1016/j.amjsurg.2011.03.006. Epub 2011 Jul 23.
Laparoscopic antireflux surgery is an accepted treatment for persistent gastroesophageal reflux but about 4% of patients will eventually require revision surgery.
We searched The Cochrane Collaboration, Medline, and EMBASE databases, augmented by Google Scholar and PubMed related articles from January 1, 1990, to November 22, 2010. Twenty studies met the inclusion criteria, reporting on 930 surgeries.
The mean surgical duration was 166 minutes and conversion to open revision fundoplication was required in 7% of cases. Complications were reported in 14% of cases and the mean length of stay varied between 1.2 and 6 days. A good to excellent result was reported for 84% of surgeries and 5% of patients required a further revisional procedure.
Laparoscopic revision antireflux surgery appears to be feasible and safe, but subject to somewhat greater risk of conversion, higher morbidity, longer hospital stay, and poorer outcomes than primary laparoscopic fundoplication.
腹腔镜抗反流手术是治疗持续性胃食管反流的一种公认的治疗方法，但约有 4%的患者最终需要进行翻修手术。
我们搜索了 Cochrane 协作组织、Medline 和 EMBASE 数据库，并通过 Google Scholar 和 PubMed 从 1990 年 1 月 1 日到 2010 年 11 月 22 日的相关文章进行了补充。有 20 项研究符合纳入标准，报告了 930 例手术。
平均手术时间为 166 分钟，7%的病例需要转为开放性翻修胃底折叠术。并发症在 14%的病例中报告，平均住院时间在 1.2 到 6 天之间。84%的手术效果良好到极好，5%的患者需要进一步的翻修手术。
腹腔镜翻修抗反流手术似乎是可行和安全的，但与初次腹腔镜胃底折叠术相比，翻修手术的转换风险较高、发病率较高、住院时间较长、结果较差。
