Wróblewski Tadeusz, Kobryn Konrad, Nowosad Małgorzata, Krawczyk Marek
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2016;11(2):60-6. doi: 10.5114/wiitm.2016.58947. Epub 2016 Mar 31.
Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery.
To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques.
Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17-76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP).
The mean age of the group was 47.77 years (17-80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18-144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90-300 min) and 147 min (90-210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2-16 post-operative days (POD) = Toupet) vs. 4.7 days (2-9 POD = WTP). No reoperations were performed. No major surgical complications were identified.
Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice.
胃食管反流病（GERD）被认为是上消化道（GIT）最常见的疾病之一。晚期GERD的最佳治疗选择是腹腔镜手术。
比较和评估采用两种不同技术对GERD患者进行手术治疗的结果。
2001年至2012年期间，353例患者（211例女性和142例男性），年龄在17 - 76岁（平均44岁），接受了腹腔镜抗反流手术。该研究纳入了接受杜普特胃底折叠术或弗罗布莱夫斯基·塔德乌什手术（WTP）的患者。
该组患者的平均年龄为47.77岁（17 - 80岁）。49例（32.45%）患者有严重症状，93例（61.58%）有轻度症状，9例（5.96%）有单一轻度但难以忍受的GERD体征。86例（56.95%）患者接受了杜普特胃底折叠术，65例（43.04%）患者接受了WTP。随访期为18 - 144个月。杜普特胃底折叠术和WTP手术的平均手术时间分别为164分钟（90 - 300分钟）和147分钟（90 - 210分钟）。围手术期死亡率为0.66%。术后平均住院时间为5.4天（术后2 - 16天 = 杜普特），而WTP为4.7天（术后2 - 9天）。未进行再次手术。未发现重大手术并发症。
由于术后并发症发生率低、患者生活质量良好且食管裂孔疝复发率为零，弗罗布莱夫斯基·塔德乌什手术应成为首选方法。
