Vassilakis J S, Xynos E, Kasapidis P, Chrysos E, Mantides A, Nicolopoulos N
Department of General Surgery, Medical School, University of Crete, Heraklion, Greece.
Surg Gynecol Obstet. 1993 Dec;177(6):608-16.
Thirty-five patients with gastroesophageal reflux (GER) proved on ambulatory esophageal hydrogen monitoring were surgically treated by a floppy Nissen fundoplication. Postoperatively, reflux and symptoms related to it were almost completely abolished. Transient bloating syndrome was observed in five instances. The operation significantly improved esophagitis (p < 0.01), increased lower esophageal sphincter pressure (p < 0.01) and increased amplitude of esophageal peristalsis (p < 0.01). However, postoperative motility of the esophagus as detected by manometry was still impaired as compared with that for the control group. Delayed esophageal transit did not improve postoperatively, although no dysphagia was accounted. Impaired esophageal motility in GER was associated with delayed gastric emptying, which, however, improved postoperatively. It is concluded that esophageal and gastric motor abnormalities are rather primary disorders in GER. After successful fundoplication, esophageal dysmotility, aggravated by reflux esophagitis, improves to some extent, while gastric emptying is enhanced.
35例经动态食管氢监测证实有胃食管反流（GER）的患者接受了软性Nissen胃底折叠术治疗。术后，反流及与之相关的症状几乎完全消失。5例出现短暂性腹胀综合征。该手术显著改善了食管炎（p < 0.01），增加了食管下括约肌压力（p < 0.01），并增加了食管蠕动幅度（p < 0.01）。然而，与对照组相比，术后通过测压法检测到的食管动力仍受损。食管传输延迟术后未改善，尽管未出现吞咽困难。GER患者食管动力受损与胃排空延迟有关，不过胃排空延迟术后有所改善。结论是食管和胃运动异常在GER中相当于是原发性疾病。成功进行胃底折叠术后，因反流性食管炎加重的食管运动障碍在一定程度上得到改善，同时胃排空增强。
