胃食管反流病的外科治疗策略  

Surgical treatment of gastroesophageal reflux disease

作　　者：林昌伟[1] 李小荣[1] 

机构地区：[1]中南大学湘雅三医院甲状腺,胃肠外科,湖南省长沙市410013

出　　处：《世界华人消化杂志》2015年第32期5093-5100,共8页World Chinese Journal of Digestology

摘　　要：胃食管反流病(gastroe sophageal reflux disease,GERD)是一种十分常见的消化系统疾病,近年来其发病率在我国乃至世界范围内都逐年上升,严重危害人们的身心健康.由于早期外科治疗存在较多术后并发症,个别术式术后复发率高,导致外科治疗GERD并未得到足够的重视.近年来随着外科抗反流手术技术的持续改进和腔镜技术的广泛开展,外科治疗逐渐被大量的长期随访研究证实具有良好的安全性和有效性.为获得最佳的外科治疗效果,外科医师应熟练掌握各种抗反流手术技巧,并能在病例选择和外科手术治疗方案的选择中做出最佳抉择.从而尽可能地减少手术并发症,降低术后GERD的复发率.但受到地区经济和外科医师技术水平差异性的限制,不同区域所能开展的外科手术治疗方案不尽相同.鉴于此,本文将对国内外常用胃食道反流病的各外科手术治疗方案作一综述,探讨各外科手术治疗方案的优缺点,以期为临床医生外科治疗的病例选择和手术方案提供有益的参考.Gastroesophageal reflux disease（GERD）is a very common foregut disease prevalent worldwide.The prevalence of GERD has risen strikingly over the past decades,causing substantial health and economic burdens.Due to high rates of recurrent reflux symptoms,reoperations and complications,surgical therapy of GERD did not attach enough attention in its early stage.However,surgical therapy for GERD was subsequently revolutionized by the development of antireflux surgical techniques and the introduction and popularization of minimally invasive surgeries.Anti-reflux surgery has gradually proved to be a well-documented,effective,therapeutic option for GERD by long-term follow-up studies.In order to improve results and to reduce unwanted effects,surgeons should master the indications of surgery and techniques of anti-reflux surgery.Besides,choosing appropriate candidates and surgical approach is also crucial for outcomes.However,limited by the regional economy and surgeon＇s skill,the use of anti-reflux surgery is still very limited.The aim of this review is to analyze and discuss the current spectrum of surgical therapy of GERD,and to provide orientation for surgeons in the challenging therapy of GERD.

关 键 词：胃食管反流病 外科治疗 胃底折叠术 减肥手术 内镜抗反流手术 LINX 

分 类 号：R656.6[医药卫生—外科学]