Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
Asian J Surg. 2019 Apr;42(4):557-562. doi: 10.1016/j.asjsur.2018.09.003. Epub 2018 Oct 10.
Laparoscopic antireflux surgery is a standard surgical treatment method for gastroesophageal reflux disease (GERD) in Western countries. However, the procedure has not been actively carried out in Korea because of concerns regarding surgical complications. Here, we conducted this study to evaluate short-term surgical outcomes of laparoscopic Nissen fundoplication (LNF) performed at a single institution.
From January 2010 to August 2016, totally 29 patients underwent LNF for GERD performed by three surgeons at Asan Medical Center, Korea. All patients participated in a telephonic survey including the presence of symptoms and the status of quality of life (QOL).
The median age at operation and BMI were 54 years and 23.8 kg/m, respectively. Preoperatively, 27 patients (93.1%) underwent PPI therapy. All patients had typical or atypical GERD symptoms. One patient (3.4%) required reoperation because of total gastroesophageal junction obstruction. 24 patients (82.8%) reported complete or partial resolution of symptoms, whereas 21 (72.4%) reported partial or complete improvement in quality of life. In patients with reflux esophagitis, GERD symptoms were significantly relieved after LNF (P = 0.005). LNF responders tended to perceive an improvement in quality of life post operation (P < 0.001).
LNF is a feasible, safe, and effective treatment option for controlling GERD symptoms as well as improving the quality of life. Presence of reflux esophagitis was a predictor of successful outcomes.
腹腔镜抗反流手术是西方国家治疗胃食管反流病（GERD）的标准手术方法。然而，由于对手术并发症的担忧，该手术在韩国并未得到积极开展。在这里，我们进行了这项研究，以评估单一机构进行的腹腔镜 Nissen 胃底折叠术（LNF）的短期手术结果。
从 2010 年 1 月到 2016 年 8 月，共有 29 名患者在韩国的 Asan 医疗中心由三位外科医生进行了 LNF 治疗 GERD。所有患者均通过电话调查参与，内容包括症状存在情况和生活质量（QOL）状况。
手术时的中位年龄和 BMI 分别为 54 岁和 23.8kg/m。术前，27 名患者（93.1%）接受了 PPI 治疗。所有患者均有典型或非典型的 GERD 症状。1 名患者（3.4%）因全胃食管交界处梗阻需要再次手术。24 名患者（82.8%）报告症状完全或部分缓解，而 21 名患者（72.4%）报告生活质量部分或完全改善。在反流性食管炎患者中，LNF 后 GERD 症状明显缓解（P=0.005）。LNF 应答者倾向于术后感知到生活质量的改善（P<0.001）。
LNF 是一种可行、安全且有效的治疗 GERD 症状和提高生活质量的选择。存在反流性食管炎是手术成功的预测因素。
