中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (07): 807-810.DOI: 10.19538/j.cjps.issn1005-2208.2023.07.19

• 论著 • 上一篇    下一篇

腹腔镜Heller肌切开联合Dor胃底折叠术治疗贲门失弛缓症22例临床分析

阿力木江·麦斯依提，伊比提哈尔·买买提艾力，李义亮，麦麦提艾力·麦麦提明，李慧灵，克力木·阿不都热依木
  

  1. 新疆维吾尔自治区人民医院微创外科、疝和腹壁疝外科  新疆胃食管反流病及减重代谢外科临床医学研究中心 新疆维吾尔自治区普外微创研究所，新疆乌鲁木齐 830001
  • 出版日期:2023-07-01 发布日期:2023-07-23

  • Online:2023-07-01 Published:2023-07-23

摘要： 目的    分析腹腔镜Heller肌切开联合Dor胃底折叠术治疗贲门失弛缓症的临床疗效。方法    回顾性分析2010年1月至2022年8月新疆维吾尔自治区人民医院微创外科、疝和腹壁疝外科收治的22例贲门失弛缓症病人的临床资料，均行腹腔镜Heller肌切开联合Dor胃底折叠术治疗。分析手术时间、术中出血量、并发症及术后复发情况，并进行随访观察。结果    22例病人均通过高分辨率食管测压明确诊断为贲门失弛缓症，其中芝加哥分类Ⅰ型3例，Ⅱ型17例，Ⅲ型2例，均顺利在胃镜引导下完成腹腔镜手术（双镜联合），无中转开放手术病例，手术时间为75.8（55～120）min，术中出血18.5（5～30）mL，未发生食管瘘，术后住院时间为3.5（2～7）d。术后随访3个月至8年，中位随访时间为4.6年，无复发病例。结论    胃镜直视下行腹腔镜Heller肌切开联合胃底折叠术治疗贲门失弛缓症安全可行。

关键词: 贲门失弛缓症, Heller肌切开术, 胃底折叠术, 高分辨率食管测压

Abstract: Clinical analyses of 22 cases of laparoscopic Heller myotomy and Dor fundoplication for treating achalasia                Alimujiang·Maisiyiti, Yibitihaer·Maimaitiaili, LI Yi-liang, et al. Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery  & Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery & Research Institute of General and Minimally Invasive Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
Corresponding author: Kelimu·Abudureyimu, E-mail: klm6075@163.com
Abstract    Objective    To investigate the efficacy of laparoscopic Heller myotomy and Dor fundoplication for Achalasia patients. Methods    The clinical data of 22 Achalasia patients were retrospectively analyzed who were diagnosed and treated during January 2010 to August 2022 in the People’s Hospital of Xinjiang Uyghur Autonomous Region. Operative time, introperative bleeding, complications, and recurrence rate were observed. Results    All 22 patients were confirmed as achalasia with high resolution manometry. According to Chicago classification, 3 patients were Type Ⅰ, 17 patients were type Ⅱ, 2 patients were type Ⅲ achalasia, and all patients successfully performed laparoscopic Heller myotomy and Dor fundoplication under endoscope navigation. The average operative time were 75.8 (55-120) min, the average blood loss were 18.5 (5-30) mL, and no occurrence of gastrointestinal fistula. The mean postoperative hospital stay were 3.48 (2-7) d. The mean postoperative follow-up was 4.6 years (3 months to 8 years), and no recurrence was observed during the follow-up. Conclusion    Laparoscopic Heller myotomy and Dor fundoplication under endoscopic navigation are an effective and safe surgical procedures of minimal invasion for Achalasia.

Key words: achalasia, Heller myotomy, fundoplication, high resolution manometry