The Fourth Department of the Digestive Disease Center, Suining Central Hospital, Sichuan, 629000, China.
The First Department of the Digestive Disease Center, Suining Central Hospital, Sichuan, China.
Langenbecks Arch Surg. 2021 Aug;406(5):1397-1405. doi: 10.1007/s00423-021-02156-2. Epub 2021 Apr 6.
Although laparoscopic Nissen fundoplication (LNF) is a kind of minimally invasive surgery, some transition time may still be required to allow the fundoplicated stomach to adapt to the new anatomical position. We observed transient delayed gastric emptying (DGE) post-LNF in our preliminary study. This study aimed to investigate the occurrence rate and development of transient DGE post-LNF.
Patients who underwent LNF for gastroesophageal reflux disease (GERD) at our institution were recruited consecutively. They were treated with standardized LNF and prospectively followed up for 2 months. Proper diet guidance and/or pharmacologic therapy were given during these 2 months. GERD Health-Related Quality of Life (GERD-HRQL), DGE symptoms, and DGE status were evaluated preoperatively and postoperatively.
Fifty-one patients underwent LNF and completed a 2-month follow-up. LNF succeeded in all patients. Prior to LNF, no DGE was identified. At the 1-month follow-up, LNF led to a significant reduction in the GERD-HRQL total score but a significantly increased DGE score. Endoscopically, DGE was identified in forty-seven (n = 47, 92.2%) patients. At the 2-month follow-up, the GERD-HRQL scores continued to show decreases compared to the 1 month. The DGE score returned to the baseline value. Endoscopically, no DGE was identified in any patients (n = 0, 0.0%).
Transient DGE is a very common one-month post-LNF but can recover quickly in the second month following LNF.
尽管腹腔镜胃底折叠术（LNF）是一种微创手术，但胃底折叠后的胃可能仍需要一段时间来适应新的解剖位置。我们在初步研究中观察到 LNF 后存在短暂的胃排空延迟（DGE）。本研究旨在探讨 LNF 后 DGE 的发生率和发展情况。
连续招募在我院行腹腔镜胃底折叠术（LNF）治疗胃食管反流病（GERD）的患者。对所有患者采用标准化的 LNF 治疗，并在术后 2 个月内进行前瞻性随访。在这 2 个月期间给予适当的饮食指导和/或药物治疗。术前和术后分别评估 GERD 健康相关生活质量（GERD-HRQL）、DGE 症状和 DGE 状态。
51 例患者接受了 LNF 手术并完成了 2 个月的随访。所有患者的 LNF 均成功完成。在 LNF 之前，没有发现 DGE。在 1 个月的随访时，LNF 导致 GERD-HRQL 总分显著降低，但 DGE 评分显著升高。内镜检查发现 47 例（n = 47，92.2%）患者存在 DGE。在 2 个月的随访时，与 1 个月相比，GERD-HRQL 评分继续下降。DGE 评分恢复到基线值。内镜检查时，所有患者（n = 0，0.0%）均未发现 DGE。
LNF 术后 1 个月内出现短暂的 DGE 非常常见，但在 LNF 后第二个月可迅速恢复。
