Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, 5042, Australia.
J Gastrointest Surg. 2012 Dec;16(12):2297-303. doi: 10.1007/s11605-012-1954-y. Epub 2012 Jul 6.
Laparoscopic Nissen fundoplication is the standard operation for the surgical control of gastro-oesophageal reflux in many centres. However, in some patients, it can be followed by troublesome side effects, and to minimise the risk of these, partial fundoplications have been recommended. One approach is to construct an anterior 180° partial fundoplication. Randomised trials and a large outcome study have confirmed that in most patients, this approach achieves effective reflux control, as well as a reduced incidence of side effects. In this paper, we describe our approach to this procedure. The procedure entails full dissection of the oesophageal hiatus, hiatal repair with posteriorly placed sutures and then construction of an anterior 180° partial fundoplication using three sutures to attach the anterior gastric fundus to the oesophagus and right hiatal pillar, and two further sutures between the fundus and the apex of the hiatus.
腹腔镜 Nissen 胃底折叠术是许多中心治疗胃食管反流的标准手术。然而，在某些患者中，它可能会引起麻烦的副作用，为了最大限度地降低这些风险，已经推荐了部分胃底折叠术。一种方法是构建前 180°部分胃底折叠术。随机试验和一项大型结果研究证实，在大多数患者中，这种方法可实现有效的反流控制，同时副作用的发生率降低。本文介绍了我们对该手术的方法。该手术需要充分解剖食管裂孔，用后方缝线进行裂孔修复，然后使用三个缝线将胃前底与食管和右侧裂孔柱连接起来，构建前 180°部分胃底折叠术，再用另外两个缝线将胃底与裂孔顶点连接起来。
