贲门失弛缓症行 Heller 肌切开术和 Toupet 胃底折叠术后的长期症状缓解和患者满意度。
Long-term symptom relief and patient satisfaction after Heller myotomy and Toupet fundoplication for achalasia.
机构信息
Department of Surgery, Rush University Medical Center, Chicago, IL 60612, USA.
出版信息
Am J Surg. 2012 Mar;203(3):339-42; discussion 342. doi: 10.1016/j.amjsurg.2011.10.003. Epub 2012 Jan 4.
BACKGROUND
The goal of this study was to review the results, symptom relief, and patient satisfaction after laparoscopic Heller myotomy and Toupet fundoplication.
METHODS
A cohort of patients who underwent laparoscopic esophagomyotomy and a Toupet fundoplication was identified. A retrospective chart review was conducted and patients then were interviewed by telephone using a modified 5-point Likert scale.
RESULTS
Long-term follow-up data were obtained for 51 patients with a mean of 5.9 years. Thirty-two (63%) patients reported infrequent or no dysphagia. Chest pain, heartburn, or regurgitation were reported in 6 of 51 (12%) patients, 14 of 51 (27%) patients, and 11 of 51 (22%) patients, respectively. Two patients (3.9%) had pneumatic dilation and 1 patient underwent completion esophagectomy (1.9%). Thirty-three (33 of 51; 65%) patients were on acid-suppression therapy. Forty-one (80%) patients reported their overall satisfaction with the procedure was either excellent or good, and 46 of 51 (90%) patients stated they would undergo surgery again.
CONCLUSIONS
Our data show acceptable long-term results.
背景
本研究旨在回顾腹腔镜 Heller 肌切开术和 Toupet 胃底折叠术的结果、症状缓解和患者满意度。
方法
确定了一组接受腹腔镜食管肌切开术和 Toupet 胃底折叠术的患者。对病历进行回顾性分析，然后通过电话对患者进行了改良的 5 分李克特量表调查。
结果
51 例患者获得了长期随访数据，平均随访时间为 5.9 年。32 例（63%）患者报告吞咽困难症状不频繁或没有。51 例患者中有 6 例（12%）报告胸痛、烧心或反流，14 例（27%）报告胸痛、烧心或反流，11 例（22%）报告胸痛、烧心或反流。2 例（3.9%）患者接受了气囊扩张，1 例（1.9%）患者接受了食管切除术。33 例（33/51；65%）患者接受了抑酸治疗。41 例（80%）患者对手术效果非常满意或满意，46 例（51 例患者的 90%）患者表示愿意再次接受手术。
结论
我们的数据显示该手术具有可接受的长期效果。
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