腹腔镜下Heller肌切开+Dor胃底折叠术在贲门失弛缓症治疗中的应用

Laparoscopic Heller Myotomy and Dor Fundoplication for the Treatment of Cardia Achalasia

目的:探讨腹腔镜下Heller肌切开+Dor胃底折叠术治疗贲门失弛缓症的临床价值。方法:对1999年5月-2013年5月本院收治的16例贲门失弛缓症患者施行腹腔镜Heller肌切开联合Dor胃底折叠术,进行回顾性统计分析。结果:手术平均时间(105.2±25.6)min,术中平均出血(32.3±12.0)mL。其中术中食管黏膜穿破2例;反流性食管炎2例;1例仍有轻度吞咽困难。手术效果优良率87.5%(14/16)。结论:腹腔镜Heller肌切开联合Dor胃底折叠术是治疗贲门失弛缓症的首选治疗方式,术中精细操作,术后严密检查,可预防并发症的发生。

Objective： To investigate the clinical application value of Laparoscopic Heller myotomy and Dor fundnplication in treatment of aehalasia. Method： The baseline data of patients diagnosed with aehalasia from May 1999 to May 2013 was retrospectively reviewed. Result： The average operative time was （ 105.2 ± 25.6 ） minutes, and the average intraoperative blood loss was （ 32.3 ±12.0 ） mL. Where 2 cases with intranperative esophageal mucnsa perforation; 2 cases with reflux esophagitis; 1 case still with mild dysphagia. Excellent effect rate of surgery was 87.5% （ 14/16 ） . Conclusion： Laparoscopic Heller myotomy and Dot fundoplication may be the preferred surgical treatment of achalasia in some patients. Fine operation during operation and close examination after operation can prevent complications.