Ataturk Research and Training Hospital, General Surgery Department, Turkey.
Int J Surg. 2012;10(9):532-6. doi: 10.1016/j.ijsu.2012.08.001. Epub 2012 Aug 21.
Laparoscopic Nissen Fundoplication has become the gold standard surgical procedure for management of gastroesophageal reflux disease. Nissen fundoplication provides an effective barrier against reflux. The aim of this study was to evaluate early postoperative outcomes of a different surgical technique, laparoscopic fundoplication with double sided posterior gastropexy.
Data of 46 patients who underwent laparoscopic fundoplication with double sided posterior gastropexy between February 2010 and December 2011 were collected. Surgically, after Nissen fundoplication was completed, 2-4 sutures were passed through the uppermost parts of the posterior and anterior wall of the gastric wrap and then passed gently 1 cm above the celiac artery from the denser fibers of uppermost part of the arcuate ligament. Demographic data, preoperative and postoperative assesments of sympthomatic and functional outcomes of patients were recorded. Length of hospital stay, operative time, early postoperative complications and complications at 1 year follow up, early recurrence rate were also recorded.
This technique resulted in good symptomatic and clinical outcomes. Only one patient out of 45 patients was reoperated. The early recurrence rate was 2.2%.
Laparoscopic Nissen fundoplication with double sided posterior gastropexy may prevent paraesophageal herniation. It is a reasonably feasible and effective method in surgical management of GERD.
腹腔镜 Nissen 胃底折叠术已成为胃食管反流病治疗的金标准手术。Nissen 胃底折叠术提供了一种有效的抗反流屏障。本研究旨在评估一种不同手术技术，腹腔镜胃底折叠术加双侧胃后固定术的早期术后结果。
收集了 2010 年 2 月至 2011 年 12 月期间接受腹腔镜胃底折叠术加双侧胃后固定术的 46 例患者的数据。手术中，Nissen 胃底折叠术完成后，通过胃包裹的后上壁和前上壁穿过 2-4 个缝线，然后从弓状韧带的最上部分较密集的纤维从腹腔动脉上方 1 厘米处轻轻穿过。记录患者的人口统计学数据、术前和术后症状和功能结果评估、住院时间、手术时间、早期术后并发症和 1 年随访并发症、早期复发率。
该技术产生了良好的症状和临床结果。45 例患者中仅有 1 例再次手术。早期复发率为 2.2%。
腹腔镜 Nissen 胃底折叠术加双侧胃后固定术可预防食管旁疝。它是 GERD 手术治疗的一种合理可行且有效的方法。
