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PDF(375 KB)
PDF(375 KB)
腹腔镜180°前胃底折叠术治疗胃食管反流性疾病临床研究
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。
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.
gastroesophageal refulx disease / laparoscope / fundoplication
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