Taylor T V, Knox R A, Pullan B R
Department of Surgical Gastroenterology, Manchester Royal Infirmary.
Ann R Coll Surg Engl. 1989 Jan;71(1):31-6.
An operation has been devised to prevent gastro-oesophageal reflux in which a vertical partition is made parallel to the proximal gastric lesser curvature. The technique, which can be simply, safely and rapidly performed, prevents reflux in the following ways: 1. Increasing the effective length of the 'intra-abdominal oesophagus'; 2. Increasing the crural sling and mucosal flap valve effect; 3. Sharpening the angle of entry into the gastric reservoir; 4. Creating a flutter valve and markedly reducing the gastric cross-sectional area along which reflux can occur. The stomach is neither opened nor divided. The efficacy of the operation was investigated in six dogs which had their lower oesophageal sphincter excised by circular myomectomy before vertical gastric plication. Pre- and postoperative manometric and oesophageal pH studies were performed. Vertical gastric plication prevented the oesophagitis produced by circular myomectomy alone. The operation has been performed in 26 patients over a 2-year period. Assessment has been by clinical methods, ambulatory 24 h pH studies and endoscopy. Twenty-one patients were classified in Visick grades I and II and ambulatory pH recordings showed a marked reduction in reflux in 13 of 14 patients. The operation is technically simple, quick and safe to perform, being accurately and scientifically reproducible.
已设计出一种手术来预防胃食管反流，即制作一个与胃近端小弯平行的垂直隔板。该技术操作简单、安全且迅速，通过以下方式预防反流：1. 增加“腹段食管”的有效长度；2. 增强膈肌脚吊带和黏膜瓣的作用；3. 锐化进入胃储器的角度；4. 创建一个扑动瓣并显著减小反流可能发生的胃横截面积。胃既不打开也不分割。在6只狗身上研究了该手术的疗效，这些狗在进行垂直胃折叠术之前通过环形肌切除术切除了食管下括约肌。进行了术前和术后的测压及食管pH值研究。垂直胃折叠术预防了仅由环形肌切除术引起的食管炎。在两年时间里，该手术已应用于26例患者。通过临床方法、24小时动态pH值研究和内镜检查进行评估。21例患者被归类为Visick I级和II级，24小时动态pH值记录显示14例患者中有13例反流明显减少。该手术技术上简单、快速且安全，具有准确且科学的可重复性。
