Chang Kenneth J, Bell Reginald
Gastroenterology and Hepatology Division, H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine Medical Center, 101 The City Drive, Orange, CA 92868, USA.
Institute of Esophageal and Reflux Surgery, 499 East Hampden Avenue #400, Englewood, CO 80113, USA.
Gastrointest Endosc Clin N Am. 2020 Apr;30(2):267-289. doi: 10.1016/j.giec.2019.12.008. Epub 2020 Feb 13.
GERD is a spectrum disorder, and treatment should be individualized to the patient's anatomic alterations. Trans-oral incisionless fundoplication (TIF 2.0) is an endoscopic procedure which reduces EGJ distensibility, thereby decreasing tLESRs, and also creates a 3-cm high pressure zone at the distal esophagus in the configuration of a flap valve. As it produces a partial fundoplication with a controlled valve diameter, gas can still escape from the stomach, minimizing the side-effect of gas-bloat. Herein we discuss the rationale, mechanism of action, patient selection, step-by-step procedure, safety and efficacy data, it's use with concomitant laparoscopic hernia repair, and future emerging indications.
胃食管反流病是一种谱系障碍性疾病，治疗应根据患者的解剖学改变进行个体化。经口无切口胃底折叠术（TIF 2.0）是一种内镜手术，可降低食管下括约肌的扩张性，从而减少下食管括约肌松弛，并且还能在食管远端形成一个3厘米高的瓣状瓣膜高压区。由于它能产生一个瓣膜直径可控的部分胃底折叠，气体仍可从胃中逸出，从而将气胀的副作用降至最低。在此，我们讨论其原理、作用机制、患者选择、分步操作过程、安全性和有效性数据、与腹腔镜疝修补术同时使用的情况以及未来新出现的适应证。
