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[抗反流腹腔镜干预]

[Antireflux laparoscopic intervention].

作者信息

Gallyamov E A, Zhenhao U, Tong Ch, Sun G

机构信息

Sechenov First Moscow State Medical University (Sechenovskiy University), Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2024(9):16-21. doi: 10.17116/hirurgia202409116.

Abstract

OBJECTIVE

To study the safety and efficacy of laparoscopic fundoplication and hiatal hernia repair for gastroesophageal reflux disease following hiatal hernia.

MATERIAL AND METHODS

We retrospectively analyzed 56 patients with gastroesophageal reflux disease and hiatal hernia .They underwent laparoscopic fundoplication and hiatal hernia repair between January 2020 and January 2023.

RESULTS

All surgeries were successful without conversion to open surgery. Surgery time was 56-180 min (mean 68.4±3.6), blood loss 30-200 ml (mean 40.3±5.6). No mortality and severe complications occurred. All patients were followed-up for 6-24 months. The GERD-Q and De Meester scores were significantly lower after 6 months compared to baseline values ( <0.05), and resting pressure was lower. Tone of lower esophageal sphincter was significantly higher compared to preoperative level ( <0.05). In 1-2 years after surgery, symptoms completely disappeared in 48 patients and significantly improved in 6 patients. Two patients had no improvement. Contrast-enhanced examination found no recurrent hiatal hernia and digestive tract obstruction.

CONCLUSION. L: Aparoscopic fundoplication and hiatal hernia repair is safe and effective for gastroesophageal reflux disease with hiatal hernia.

摘要

目的

研究腹腔镜胃底折叠术及食管裂孔疝修补术治疗食管裂孔疝后胃食管反流病的安全性和有效性。

材料与方法

我们回顾性分析了56例胃食管反流病合并食管裂孔疝患者。他们于2020年1月至2023年1月接受了腹腔镜胃底折叠术及食管裂孔疝修补术。

结果

所有手术均成功,未转为开放手术。手术时间为56 - 180分钟(平均68.4±3.6),失血量30 - 200毫升(平均40.3±5.6)。无死亡及严重并发症发生。所有患者均随访6 - 24个月。6个月后GERD - Q和De Meester评分与基线值相比显著降低(<0.05),静息压力降低。食管下括约肌张力较术前水平显著升高(<0.05)。术后1 - 2年,48例患者症状完全消失,6例患者症状明显改善。2例患者无改善。造影检查未发现食管裂孔疝复发及消化道梗阻。

结论

腹腔镜胃底折叠术及食管裂孔疝修补术治疗食管裂孔疝合并胃食管反流病安全有效。

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