腹腔镜胃底折叠术联合胃悬吊术治疗胃食管反流病合并胃下垂的疗效分析  

The effect of laparoscopic fundoplication combined with gastric suspension in the treatment of gastroesophageal reflux disease with gastroptosis

作　　者：李治仝[1] 张瑞[2] 符洋[1] Li Zhitong;Zhang Rui;Fu Yang(Gastrointestinal Surgery/Hernia and Abdominal Wall Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院胃肠外科/疝和腹壁外科,郑州450052 [2]郑州大学第一附属医院肿瘤科,郑州450052

出　　处：《中华普通外科杂志》2024年第6期435-438,共4页Chinese Journal of General Surgery

摘　　要：目的探讨腹腔镜胃底折叠术联合胃悬吊术治疗胃食管反流病合并胃下垂的疗效。方法回顾性分析2017年1月至2020年6月在郑州大学第一附属医院接受腹腔镜胃底折叠术联合胃悬吊术治疗胃食管反流病合并胃下垂49例患者的临床资料,并评价手术疗效。结果本组49例患者均成功行腹腔镜胃底折叠术(Toupet或Dor胃底折叠术)联合胃悬吊术。与术前相比,术后3年的反酸、烧心、腹胀、嗳气及咳嗽症状评分均降低,差异均有统计学意义(Z=-4.553、-4.226、-3.529、-3.314、-3.192,均P<0.001)。与术前相比,术后3年的生活质量SF-36量表中生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、心理健康的差异均有统计学意义(Z=-2.297、-3.524、-2.771、-3.176、-3.731、-3.631、-3.626、-3.630,均P<0.001)。术后3年复查消化道X线造影均未显示胃食管反流和胃下垂。结论腹腔镜胃底折叠术联合胃悬吊术治疗胃食管反流病合并胃下垂安全、有效。Objective To investigate the effect of laparoscopic fundoplication combined with gastric suspension in the treatment of gastroesophageal reflux disease(GERD)with gastroptosis.Methods A retrospective cohort study was made in 49 patients of GERD with gastroptosis treated by laparoscopic fundoplication combined with gastric suspension at the First Affiliated Hospital of Zhengzhou University from Jan 2017 to Jun 2020.Meanwhile,the clinical characteristics and surgical effect were summarized.Results Forty-nine patients successfully undrwent laparoscopic fundoplication(Toupet or Dor fundoplication)combined with gastric suspension.After 3 years of follow-up,compared with the preoperation,the postoperative symptom scores of acid reflux,heartburn,abdominal distension,belching and cough were lower,and the differences were statistically significant(Z=-4.553,-4.226,-3.529,-3.314,-3.192,all P<0.001).At the same time,compared with preoperation,physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional,mental health on the SF-36 scale were significant differences.The differences were also statistically significant(Z=-2.297,-3.524,-2.771,-3.176,-3.731,-3.631,-3.626,-3.630,all P<0.001).Gastroesophageal reflux and gastroptosis were not found in the gastrointestinal radiography 3 years after operation.Conclusion Laparoscopic fundoplication combined with gastric suspension for GERD with gastroptosis is safe,effective and worthyofrecommendation.

关 键 词：胃食管反流 胃底折叠术 胃下垂 胃悬吊术 

分 类 号：R656.61[医药卫生—外科学]