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胃食管反流相关慢性咳嗽行抗反流手术治疗的疗效及安全性:一项荟萃分析。

Efficacy and safety of fundoplication in treating gastroesophageal reflux-related chronic cough: A meta-analysis.

机构信息

Department of Gastroesophageal Reflux Disease, PLA Rocket Force Characteristic Medical Center, Beijing, China.

Department of Gastroesophageal Reflux Disease, PLA Rocket Force Characteristic Medical Center, Beijing, China.

出版信息

Asian J Surg. 2024 Oct;47(10):4281-4286. doi: 10.1016/j.asjsur.2024.03.008. Epub 2024 Mar 15.

Abstract

Gastroesophageal reflux related chronic cough (GERC), is a common type of chronic cough. Drug treatment is the first choice. But some patients are tired of taking medicine everyday and some patients can not benefit from drugs. For these patients, fundoplication may be the most effective method. However, the importance of fundoplication in treating GERC is undervalued, and there is very few meta-analysis looking into the effect and safety of fundoplication in treating GERC. To solve this question, we performed this meta-analysis. The PRISMA strategy was used for this study. Our study was registered with PROSPERO (ID: CRD42021251072). We searched PubMed, Medline, Web of Science, and the Cochrane databases from 1990 to December of 2022. The meta-analysis was performed with Review Manager 5.4 and Stata 14. After selection and exclusion, 15 articles out of 672 were included. The meta-analysis showed that the cure rate of laparoscopic fundoplication in treating GERC was 58% (95%CI: 52%-65%), with I = 45%; and the effective rate was 86% (95%CI: 80%-93%), with I = 0%. Laparoscopic fundoplication is effective for the most of GERC patients; however, when the goal is to cure GERC completely, a relatively conservative attitude should be taken. In terms of safety, laparoscopic fundoplication is quite reliable offered by skilled surgeons.

摘要

胃食管反流相关的慢性咳嗽(GERC)是一种常见的慢性咳嗽类型。药物治疗是首选。但有些患者每天服药感到厌烦,有些患者则不能从药物中获益。对于这些患者,胃底折叠术可能是最有效的方法。然而,胃底折叠术治疗 GERC 的重要性被低估了,很少有荟萃分析研究胃底折叠术治疗 GERC 的效果和安全性。为了解决这个问题,我们进行了这项荟萃分析。本研究采用 PRISMA 策略。我们的研究已在 PROSPERO(ID:CRD42021251072)上注册。我们从 1990 年到 2022 年 12 月检索了 PubMed、Medline、Web of Science 和 Cochrane 数据库。使用 Review Manager 5.4 和 Stata 14 进行荟萃分析。经过筛选和排除,从 672 篇文章中选出 15 篇纳入分析。荟萃分析显示,腹腔镜胃底折叠术治疗 GERC 的治愈率为 58%(95%CI:52%-65%),I²=45%;有效率为 86%(95%CI:80%-93%),I²=0%。腹腔镜胃底折叠术对大多数 GERC 患者有效;然而,当目标是完全治愈 GERC 时,应采取相对保守的态度。就安全性而言,熟练的外科医生进行的腹腔镜胃底折叠术是非常可靠的。

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