腹腔镜Nissen胃底折叠术治疗胃食管反流病

Laparoscopic Nissen fundoplication for treatment of gastroesophageal reflux disease

目的探讨腹腔镜Nissen胃底折叠术治疗胃食管反流病的效果。方法对近2年来收治的109例胃食管反流病实施腹腔镜Nissen胃底折叠术患者的临床资料进行回顾性分析。结果108例成功完成手术,1例因难以控制的脾上极胃短血管出血而中转开腹。手术用时30～245(平均68.1)min,术中出血5～450(平均30.0)mL;术后住院天数2～8(平均4.2)天。术后102例获3～27个月的随访,7例失访。随访患者中99例(97.1%)反酸、烧心等消化道症状基本消失,2例(2.0%)明显缓解,1例(0.9%)无效。术后2例出现较严重的吞咽困难,1例严重上腹胀气,2例腹泻,1例出现术后食管裂孔疝。结论腹腔镜Nissen胃底折叠术是治疗胃食管反流病的一种微创、安全、有效的治疗方法。

Objective To observe the clinical effects and complications of laparoseopic Nissen fundoplication （LNF） in treatment of gastroesophageal reflux disease （GERD）. Methods From November 2006 to November 2008, 109 consecutive patients with GERD were treated by LNF. The clinical records of these patients were retrospectively analyzed. Results All patients, except one ease converted to laparotomy because of bleeding from short gastric vessel. The mean operation time was 68. 1 rain （ 30 - 245 rain ） ; mean intraoperative blood loss was 30.0 mL （5 -450 mL） ; and mean postoperative hospital stay was 4.2 d （2-8 d）. Postoperatively, 102 patients were followed-up for 3 to 27 months, and among them, 99 patients （97. 1% ） had complete resolution of their digestive symptoms such as regurgitation and heartburn, 2 patients （2. 0% ） had symptoms markedly relieved, and 1 patient （0. 9% ） had not improved. Postoperative complications included severe dysphagia in 2 eases, bloating in 1 ease, diarrhea in 2 eases and postoperative hiatal hernia in 1 case. Conclusions Laparoseopie Nissen fundoplication is a minimally-invasive, safe and effective proeedure in the treatment of gastroesophageal reflux disease.