Trus T L, Laycock W S, Branum G, Waring J P, Mauren S, Hunter J G
Department of Surgery, Emory University, Atlanta Georgia, USA.
Am J Surg. 1996 Jan;171(1):32-5. doi: 10.1016/S0002-9610(99)80069-5.
Open antireflux surgery is an established long-term treatment for chronic gastroesophageal reflux disease. Short-term results of laparoscopic antireflux surgery are excellent, but long-term follow-up is not yet available.
Twenty-four-hour ambulatory esophageal pH monitoring and symptom scores were collected prior to laparoscopic antireflux surgery and 6 weeks postoperatively. These studies were repeated in an unselected cohort of patients 1 to 3 years after operation.
One hundred patients who were > 1 year from surgery at the time of the present study volunteered for intermediate follow-up symptom assessment, and 35 also completed repeat 24-hour monitoring. The median interval after surgery among these volunteers was 17 months. Thirty-three (94%) had a normal pH study, which correlated with improvements in symptom scores. One patient had an abnormal pH study but no reflux symptoms, and 1 patient with an abnormal study developed recurrent symptoms of reflux after an episode of vomiting 11 months postoperatively.
The intermediate-term results of laparoscopic fundoplication suggest that long-term efficacy of this operation will be equivalent to open fundoplication.
开放抗反流手术是治疗慢性胃食管反流病的一种既定的长期治疗方法。腹腔镜抗反流手术的短期效果极佳,但尚未有长期随访结果。
在腹腔镜抗反流手术前及术后6周收集24小时动态食管pH监测数据和症状评分。在术后1至3年对一组未经挑选的患者重复进行这些研究。
在本研究时,100名距离手术超过1年的患者自愿接受中期随访症状评估,其中35名还完成了重复的24小时监测。这些志愿者术后的中位间隔时间为17个月。33名(94%)患者的pH研究结果正常,这与症状评分的改善相关。1名患者的pH研究结果异常但无反流症状,1名研究结果异常的患者在术后11个月呕吐一次后出现了反流复发症状。
腹腔镜胃底折叠术的中期结果表明,该手术的长期疗效将与开放胃底折叠术相当。