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腹腔镜下尼森-罗塞蒂胃底折叠术治疗胃食管反流病:长期临床疗效及生活质量评估

LAPAROSCOPIC NISSEN ROSETTI FUNDOPLICATION IN TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE: EVALUATION OF LONG TERM CLINICAL OUTCOMES AND QUALITY OF LIFE.

作者信息

Tezcaner T, Tezel E, Anadol A, Ersoy E

机构信息

Baskent University School of Medicine, Department of General Surgery; Gazi University School of Medicine, Medistate Hospital, Department of General Surgery, Ankara, Turkey.

Baskent University School of Medicine, Department of General Surgery.

出版信息

Georgian Med News. 2019 Feb(287):7-12.

Abstract

The aim of this study is to evaluate outcomes of Nissen-Rossetti fundoplication in-terms of objective measures and quality of life evaluation instruments. For the period in observation, the chronic GERD patients, who had undergone LNRF surgery, were evaluated. The long-term outcome was assessed by subjectively comparing the preoperative and postoperative symptoms and Gastroesophageal reflux-Health related quality of life index. As an objective assessment of the pathological reflux, patients underwent 24-hour pH monitoring in the preoperative and postoperative period. Thirty-two patients, who met the criteria and volunteered to participate, were included in the study. The median postoperative follow-up period for the patients was 28±7.92 (16-52) months. A significant increase was observed in the quality of life scores in the postoperative period when compared to the preoperative period (p=0.001) and the DeMeester scores have decreased significantly (p=0.001). The postoperative dysphagia was observed even in the long term in most of the patients, without having a significant effect on the quality of life. In the treatment of gastroesophageal reflux disease, laparoscopic Nissen Rossetti fundoplication is an effective and successful method in achieving the desired outcome such as preventing pathological reflux, relieving the symptoms and improving the quality of life in the long term.

摘要

本研究的目的是从客观指标和生活质量评估工具方面评估nissen - rossetti胃底折叠术的疗效。在观察期内,对接受了nissen - rossetti胃底折叠术的慢性胃食管反流病患者进行了评估。通过主观比较术前和术后症状以及胃食管反流 - 健康相关生活质量指数来评估长期疗效。作为对病理性反流的客观评估,患者在术前和术后均接受了24小时pH监测。32名符合标准并自愿参与的患者被纳入研究。患者术后的中位随访期为28±7.92(16 - 52)个月。与术前相比,术后生活质量评分显著提高(p = 0.001),DeMeester评分显著降低(p = 0.001)。大多数患者即使在长期也观察到术后吞咽困难,但对生活质量没有显著影响。在胃食管反流病的治疗中,腹腔镜nissen rossetti胃底折叠术是一种有效且成功的方法,能够实现如预防病理性反流、缓解症状和长期改善生活质量等预期效果。

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