Roberts P J, Cuschieri A
Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Scotland.
Ann Chir Gynaecol. 1995;84(2):130-7.
Despite new effective drugs, like omeprazole, reducing gastric acid output and relieving gastro-oesophageal reflux disease (GERD) symptoms in most patients, there are still clear indications for surgical treatment of this chronic disease. The main indications are failure to control symptoms by medical treatment, noncompliance to medication and development of complications. Recent developments in minimal access surgery have modified the surgical approach to the treatment of GERD. The antireflux surgical procedures can be endoscopically performed reproducing all the essential component steps of the equivalent open operations, but with all the advantages of minimal access surgery. The fundoplication procedures are mainly performed laparoscopically and the thoracoscopic approach is chosen in patients with short oesophagus, morbid obesity or other contraindications to the laparoscopic approach. The short-term results of endoscopic antireflux surgery are at least as good than after open surgery. A review on the laparoscopic and thoracoscopic antireflux procedures is presented.
尽管有新的有效药物，如奥美拉唑，可减少胃酸分泌并缓解大多数患者的胃食管反流病（GERD）症状，但对于这种慢性病的手术治疗仍有明确指征。主要指征包括药物治疗无法控制症状、不依从药物治疗以及出现并发症。微创外科手术的最新进展改变了GERD的手术治疗方法。抗反流手术可通过内镜进行，重现等效开放手术的所有基本组成步骤，但具有微创外科手术的所有优点。胃底折叠术主要通过腹腔镜进行，对于食管短、病态肥胖或有腹腔镜手术其他禁忌证的患者，则选择胸腔镜手术方法。内镜抗反流手术的短期效果至少与开放手术后一样好。本文对腹腔镜和胸腔镜抗反流手术进行综述。
