腹腔镜前180°胃底折叠术治疗反流性食管炎89例临床分析

Clinical analysis of 89 cases of reflux esophagitis treated by laparoscopic anterior 180°fundus folding

目的探讨腹腔镜前180°胃底折叠术治疗反流性食管炎的安全性及有效性。方法回顾分析2016年1月至2022年12月于天津医科大学南开临床学院接受腹腔镜180°前胃底折叠术的89例反流性食管炎患者的临床资料,并对患者进行术后6、12个月随访。比较术前、术后反流症状评分(GERD-Q)、生活质量评分(GERD-QOL)、手术时间、术中出血量及术后1个月并发症情况。结果手术均成功,平均手术时间(85.3±6.5)min,术中平均出血(10.7±5.301)ml,术后平均住院时间(4.53±1.67)d;与术前相比,术后患者的GERD-Q和GERD-QOL评分显著降低(均P<0.05)。术后平均随访18个月,术后1年内随访GERD-Q量表提示疗效满意率达88%。结论腹腔镜前180°胃底折叠术治疗反流性食管炎是一种安全、有效的术式。

Objective To investigate the reliability and effect of laparoscopic 180°anterior fundoplication for reflux esophagitis.Methods The clinical data of 89 patients with reflux esophagitis who underwent laparoscopic 180°anterior fundoplication from January 2016 to December 2022 were retrospectively analyzed,and the patients were followed up at 6,and 12 months after surgery.The preoperative and postoperative reflux symptom scores(GERD-Q),quality of life scores(GERD-QOL),operative time,intraoperative bleeding,and postoperative complications were compared.Results All surgeries were successful,with a mean operative time of(85.3±6.5)minutes,a mean intraoperative bleeding of(10.7±5.301)ml,and a mean postoperative hospitalization of(4.53±1.67)d;GERD-Q and GERD-QOL scores of the patients were significantly lower in the postoperative period compared with the preoperative period(both P<0.05).The average postoperative follow-up was 18 months,and the follow-up GERD-Q scale within 1 year after surgery suggested a satisfactory efficacy rate of 88%.Conclusion Laparoscopic anterior 180°fundoplication for reflux esophagitis is a safe and effective procedure.