Danilova D A, Bazaev A V, Gorbunova L I
Privolzhsky Research Medical University of the Ministry of Health of the Russia, Nizhniy Novgorod, Russia.
Khirurgiia (Mosk). 2020(2):89-94. doi: 10.17116/hirurgia202002189.
Gastroesophageal reflux disease (GERD) is characterized by abnormal reflux of gastric content into the esophagus, pharynx, respiratory tract and oral cavity. In recent years, there has been a significant increase of the incidence of this disease, that significantly aggravates quality of life of the population. The 'gold standard' for treating GERD is anti-secretory therapy with proton pump inhibitors (PPIs). However, up to 40% of patients are unresponsive to PPIs even after dose adjustment. Advantages and disadvantages of modern surgical approaches for this pathology are reviewed. Laparoscopic fundoplication including Nissen (360°), Toupet (270°) and Dor procedures (180°) is the most common anti-reflux operation. In addition, new alternative surgical options are also discussed. For example, these are minimally invasive methods such as LINX reflux control system, electrical stimulation of the lower esophageal sphincter and transoral incisionless fundoplication (TIF). These methods are less aggressive and have less side effects. A comparative assessment of modern methods of surgical treatment of GERD is made.
胃食管反流病（GERD）的特征是胃内容物异常反流至食管、咽部、呼吸道和口腔。近年来，这种疾病的发病率显著上升，严重影响了人们的生活质量。治疗GERD的“金标准”是使用质子泵抑制剂（PPI）进行抗分泌治疗。然而，即使调整剂量，仍有高达40%的患者对PPI无反应。本文综述了现代手术治疗该疾病的优缺点。腹腔镜胃底折叠术包括nissen（360°）、Toupet（270°）和Dor手术（180°）是最常见的抗反流手术。此外，还讨论了新的替代手术选择。例如，这些是微创方法，如LINX反流控制系统、食管下括约肌电刺激和经口无切口胃底折叠术（TIF）。这些方法侵袭性较小，副作用也较少。对GERD现代手术治疗方法进行了比较评估。
