中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (02): 138-140.

• 论著 • 上一篇    下一篇

腹腔镜180°前胃底折叠术治疗胃食管反流性疾病临床研究

秦鸣放， 孙向宇   

  1. 天津市南开医院微创外科 天津市微创外科中心, 天津300100
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-03-03 发布日期:2009-03-03

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-03-03 Published:2009-03-03

PDF

摘要：

目的 探讨腹腔镜180°前胃底折叠术治疗胃食管反流性疾病（gastroesophageal refulx disease，GERD）的安全性及有效性。 方法 2005年1月至2008年4月采用腹腔镜180°前胃底折叠术治疗胃食管反流性疾病54例，术后随访3~25个月，对酸反流的主观和客观指标进行分析。 结果 腹腔镜180°前胃底折叠术治疗术后反酸症状完全消失，食管下段测压由术前（6.7±1.3）mmHg（1mmHg=0.133kPa），提高到术后6个月（19.1±3.4）mmHg（P1＜0.01），术后1年（21.6±1.8）mmHg（P2＜0.01），24h pH监测DeMeester评分由术前97.2±2.7降低到术后6个月6.4±2.2（P1＜0.01），术后1年6.7±2.3（P2＜0.01）较术前明显改善，并达到正常范围，无术后严重并发症，无中转开腹及死亡病例。 结论 与以往较为公认的Nissen术和Toupet术相同，腹腔镜180°前胃底折叠术治疗GERD是一种安全、有效的术式，并且副反应少。

关键词: 胃食管反流性疾病, 腹腔镜, 胃底折叠术

Abstract:

Laparoscopic 180°anterior fundoplication for gastroesophageal refulx disease QIN Ming-fang，SUN Xiang-yu. Department of Mini-invasive Surgery, Tianjin Nankai Hospital, Tianjin 300100,China Corresponding author: QIN Ming-fang, E-mail: XiangYu Sun2007@Yahoo.cn Abstract Objective To investigate the reliability and effect of laparoscopic 180°anterior fundoplication for gastroesophageal refulx disease. Methods From January 2005 to April 2008, 54 cases of gastroesophageal refulx disease were treated by laparoscopic 180°anterior fundoplication. All the cases were followed up for 3 to 25 months. Results All the cases were treated by laparoscopic 180°anterior fundoplication. Laparoscopic 180°anterior fundoplication was found to provide better control of reflux related symptom. The postoperative esophageal manmometry increased from (6.7±1.3)mmHg to (19.1±3.4)mmHg（P1＜0.01） after 6 months, to (21.6±1.8 )mmHg （P2＜0.01） after 1 year. The DeMeester score of 24h pH monitor declined from 97.2±2.7 to 6.4±2.2 （P1＜0.01） after 6 months, to 6.7±2.3 （P2＜0.01） after 1 year. No postoperative complications occurred. There was no conversion to open operation and death. Conclusion Laparoscopic 180°anterior fundoplication offers the same effect as Nissen and Toupet of a high and durable level of disease control, moreover with few side effect.

Key words: gastroesophageal refulx disease, laparoscope, fundoplication