腹腔镜下胃底折叠术结合双面胃后固定术的应用分析  

Analysis laparoscopic Nissen fundoplication combine with two side posterior gastropexy

作　　者：李四桥[1] 买二辉[1] 常清潭[1] 郑幼伟[1] 

机构地区：[1]郑州大学附属洛阳中心医院普外一科,471009

出　　处：《临床外科杂志》2013年第6期441-443,共3页Journal of Clinical Surgery

摘　　要：目的 评估腹腔镜下胃底折叠术结合双面胃后固定术在治疗胃食管反流病中的临床价值.方法 2010年2月至2012年2月行腹腔镜下胃底折叠术结合双面胃后固定术的49例.在Nissen胃底折叠术完成后,将折叠部的最上部的前壁、后壁固定在弓状韧带上.记录该组患者的术前资料、住院时间、手术时间、术后早期以及1年随访时并发症、早期复发率等.结果 无转变成开放手术,患者无院内死亡,随访中无食管周围疝形成.47例患者症状均已改善,1例患者复发而行再次手术,早期复发率2.1%.患者满意度为（92.6±9.2）%.结论 腹腔镜下Nissen胃底折叠术结合双面胃后固定术能有效地预防食管周围疝形成,并将成为外科治疗胃食管反流病的可行而有效的方法之一.Objective To evaluate the clinical value of laparoscopic Nissen fundoplication com-bined with double-sided posterior gastropexy for the treatment of gastroesophageal reflux disease（GERD）. Methods The clinical data of 49 patients who underwent laparoscopic fundoplication with double-sided posterior gastropexy between February 2010 and February 2012 were collected. Surgically, after Nissen fun-doplication was completed,the uppermost parts of the posterior and anterior wall of the gastric wrap were fixed to the arcuate ligament. Preoperative data, hospital stay, operative time, early postoperative complica- tions, complications after 1-year follow-up, and early recurrence rate were recorded. Results There was no in-hospital mortality, no conversion to open surgery, and no paraesophageal hiatus herniation at 1-year fol- low-up. Forty-seven patients complained that their symptoms had improved. Only one patient was reoperat-ed for the recurrence and the early recurrence rate was 2.1%. The patient satisfaction rate was 92.6 ± 9. 2%. Conclusion Laparoscopic Nissen fundoplication with double-sided posterior gastropexy may prevent paraesophageal herniation. It could become a reasonably feasible and effective method in the surgical man-agement of GERD.

关 键 词：腹腔镜手术 胃底折叠术 双面胃后固定术 胃食管返流病 

分 类 号：R608[医药卫生—外科学]