Min Michael X, Ganz Robert A
Department of Medicine, Abbott Northwestern Hospital, Minneapolis, MN, USA.
Curr Gastroenterol Rep. 2014 Feb;16(2):374. doi: 10.1007/s11894-014-0374-4.
Gastroesophageal reflux disease (GERD) is a common and progressive condition manifested by heartburn or regurgitation. Though Nissen fundoplication has been and remains the gold standard for procedural therapy for GERD, two newer interventions have gained popularity: magnetic sphincter augmentation (MSA), which entails the placement of a self expanding magnetic ring around the gastroesophageal (GE) junction, and transoral incisionless fundoplication (TIF), an endoscopic approach that creates a neogastroesophageal valve near the fundus. Collective data gathered from four studies published within the past year suggest that the three modalities share comparable effectiveness in pH monitoring and patient satisfaction, TIF may have a lower proton pump inhibitor cessation rate, and Nissen fundoplication required longer recovery time and had a more serious adverse effects profile. Large, prospective, randomized controlled studies are needed to reliably compare the three procedures.
胃食管反流病（GERD）是一种常见的进行性疾病，表现为烧心或反流。尽管nissen胃底折叠术一直是且仍然是GERD手术治疗的金标准，但两种新的干预措施越来越受欢迎：磁括约肌增强术（MSA），即围绕胃食管（GE）交界处放置一个自膨胀磁环；经口无切口胃底折叠术（TIF），一种在内镜下在胃底附近创建新胃食管瓣膜的方法。过去一年发表的四项研究收集的综合数据表明，这三种方法在pH监测和患者满意度方面具有相当的有效性，TIF可能有较低的质子泵抑制剂停药率，nissen胃底折叠术需要更长的恢复时间且不良反应更严重。需要进行大型、前瞻性、随机对照研究来可靠地比较这三种手术。
