Champault G, Volter F, Rizk N, Boutelier P
General and GI Surgery Unit, Hospital Jean Verdier, Bondy, France.
Surg Laparosc Endosc. 1996 Dec;6(6):434-40.
Sixty-one patients with gastroesophageal reflux who did not respond to conventional medical treatment were treated in a prospective study, 29 by conventional surgery and 32 by laparoscopic methods. All underwent manometry and pH measurement preoperatively and at a follow-up of four months. There was no mortality, and the morbidity of the two groups was not significantly different at 3% and 5%. Hospital stay was significantly reduced (5.4 versus 8.9 days; p = 0.02) following laparoscopic treatment, and time off from work was 21.3 days versus 38.2 days (p = 0.02). The satisfaction index expressed by the patients was 65% at 1 month and 95% at 3 months. Dysphagia was observed in 30% of the patients at 1 month and in 3% at 4 months in both groups. The results of manometry and pH measurements at 4 months are comparable between open surgery and laparoscopy. There was one failure (3%) in the laparoscopic group caused by disruption of the valve. The mean pressure in the esophageal segment (expressed in mm Hg) changed in the two groups from 3.6 to 18.1 (p = 0.001). The results of this series show laparoscopic management of gastroesophageal reflux to be justified.
在一项前瞻性研究中，对61例经传统药物治疗无效的胃食管反流患者进行了治疗，其中29例接受传统手术，32例采用腹腔镜手术方法。所有患者在术前及术后4个月随访时均接受了测压和pH值测量。无死亡病例，两组的发病率分别为3%和5%，无显著差异。腹腔镜治疗后住院时间显著缩短（5.4天对8.9天；p = 0.02），误工时间分别为21.3天和38.2天（p = 0.02）。患者表示的满意度指数在1个月时为65%，在3个月时为95%。两组中，1个月时30%的患者出现吞咽困难，4个月时为3%。开放手术和腹腔镜手术4个月时的测压和pH值测量结果具有可比性。腹腔镜组有1例失败（3%），原因是瓣膜破裂。两组食管段的平均压力（以毫米汞柱表示）从3.6变为18.1（p = 0.001）。该系列研究结果表明，腹腔镜治疗胃食管反流是合理的。
