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抗反流手术的新进展:我们目前处于什么阶段?

New Developments in Anti-Reflux Surgery: Where Are We Now?

作者信息

Gensthaler Lisa, Schoppmann Sebastian F

机构信息

Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.

出版信息

Visc Med. 2024 Oct;40(5):250-255. doi: 10.1159/000538117. Epub 2024 Apr 9.

Abstract

BACKGROUND

Gastroesophageal reflux disease is one of the most common chronic diseases, affecting up to 28% of the western population. Therapeutic management ranges from conservative measures to endoscopic or surgical interventions. Laparoscopic Nissen fundoplication (LNF) still is considered as gold standard, but alternative procedures have been developed and evaluated within the past years.

SUMMARY

Magnetic sphincter augmentation (MSA), which aims to be a less disruptive and possibly more standardized laparoscopic procedure than LNF, shows satisfying results regarding short- and long-term follow-up as well as comorbidities. Alternatives, such as the RefluxStop™ procedure or Transoral incisionless fundoplication (TIF), combined with laparoscopic hiatal hernia repair (cTIF) show promising results for short-term follow-up, nevertheless further studies regarding long-term follow-up are necessary.

KEY MESSAGE

Although there definitely are upcoming and promising trends in upper GI surgery, LNF still represents today's gold standard and MSA is an equivalent alternative. RefluxStop™ and cTIF show promising results, nevertheless, further studies are necessary.

摘要

背景

胃食管反流病是最常见的慢性病之一,影响着高达28%的西方人口。治疗方法包括从保守措施到内镜或手术干预。腹腔镜下尼森胃底折叠术(LNF)仍被视为金标准,但在过去几年中已开发并评估了替代手术。

总结

磁括约肌增强术(MSA)旨在成为一种比LNF破坏性更小且可能更标准化的腹腔镜手术,在短期和长期随访以及合并症方面显示出令人满意的结果。其他替代方法,如RefluxStop™手术或经口无切口胃底折叠术(TIF),结合腹腔镜食管裂孔疝修补术(cTIF)在短期随访中显示出有前景的结果,然而仍需要关于长期随访的进一步研究。

关键信息

尽管在上消化道手术中肯定有新出现的且有前景的趋势,但LNF至今仍代表着金标准,MSA是一种等效的替代方法。RefluxStop™和cTIF显示出有前景的结果,不过仍需要进一步研究。

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本文引用的文献

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Severe Dysphagia is Rare After Magnetic Sphincter Augmentation.磁括约肌增强后很少出现严重吞咽困难。
World J Surg. 2022 Sep;46(9):2243-2250. doi: 10.1007/s00268-022-06573-2. Epub 2022 Apr 29.

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