腹腔镜Nissen胃底折叠术治疗老年重度胃食管反流病的长期疗效观察

Long-term therapic effect of laparoscopic Nissen fundoplication for elderly patients with severe gastroesophageal reflux disease

目的通过对老年重度胃食管反流病(gasroesophageal reflux disease,GERD)患者行腹腔镜Nissen胃底折叠术(laparoscopic Nissen fundoplication,LNF)的长期随访结果和对照组对比分析,评价该方法远期的安全性和有效性。方法回顾分析自2005年1月至2011年1月因重度GERD行LNF治疗的老年患者21例,与同期对照组44例对比,分析两组患者的远期治疗效果。结果两组患者均成功行LNF治疗,术后早期症状均获得缓解,手术时间和术后短期并发症两组比较无明显差异,术后胃镜见食管炎症状均较术前有所好转。术后平均随访7.4年,两组复发率比较无统计学差异,老年组远期吞咽困难发生率高于对照组。结论 LNF治疗老年重度GERD安全、有效,但远期吞咽困难发生率较高于对照组。

Objective To assess the therapic effect of laparoscopic Nissen fundoplication for elderly patients with severe gastroesophageal reflux disease （GERD） comparing to non-elderly patients. Methods Between Jan. 2005 and Jan. 2011, 65 patients admitted our centre for severe GERD and underwent laparoscopic Nissen fundoplication. 21 cases of 65 patients were older than 70 years which were divided into elderly group and the other 44 non-elderly cases were control group. The clinical data about therapies and recovery of two groups was recorded and analyzed retrospectively. Results All patients underwent laparoscopic Nissen fundoplication successfully. The clinical symptoms of two groups were relieved postoperatively. The short-term complication rate and mean operative time were no significant difference. The mean follow-up period was 7.4 years. The recurrence rate of two groups was no significant difference, but the postoperative dysphagia rate in elderly group was more than control group. Conclusions Laparoscopic Nissen fundoplication is safe and effective for elderly patients with server GERD, but the incidence of long-term dysphasia was higher.