胃食管反流病的外科治疗  

Surgical treatment strategies for gastroesophageal reflux disease

作　　者：陈双[1] 黄恩民 周太成[1] CHEN Shuang;HUANG Enmin;ZHOU Taicheng(Department of Hernia and Abdominal Wall Surgery,Sixth Affiliated Hospital,Sun Yat-sen University,Guangdong Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院疝和腹壁外科,广东广州510655

出　　处：《外科理论与实践》2024年第4期292-295,共4页Journal of Surgery Concepts & Practice

摘　　要：胃食管反流病(GERD)是一种常见的消化系统疾病,全球发病率约为13%。目前主要的手术方式包括360°的Nissen折叠术、270°的Toupet折叠术和180°的Dor折叠术。虽然Nissen术在远期效果上优于其他方法,但其术后吞咽困难发生率较高。在选择手术时,需要根据食管动力学检查和pH值进行个体化决策。手术不仅要修复解剖结构,还需恢复功能,包括恢复腹段食管长度和膈肌脚与脊柱的斜度。重建胃食管阀瓣和膈食管筋膜有助于优化手术效果并防止术后并发症发生。考虑到GERD涉及的生理和心理状态变化,个体化治疗是改善症状和提升生活质量的关键。Gastroesophageal reflux disease(GERD)is a common digestive disorder with a global prevalence of approximately 13%.The primary surgical options include the 360°Nissen fundoplication,270°Toupet fundoplication,and 180°Dor fundoplication.While the Nissen procedure demonstrates superior long⁃term outcomes compared to the other methods,it is associated with a higher incidence of postoperative dysphagia.Surgical decisions should be individualized based on esophageal motility and pH monitoring.The surgery not only aims to repair anatomical structures,but also to restore function,including the length of the abdominal esophagus and the angulation between the crura diaphragm and the spine.Reconstruction of the gastroesophageal valve and the phrenoesophageal fascia is crucial for optimizing surgical outcomes and preventing postoperative complications.Given the physiological and psychological changes associated with GERD,personalized treatment is essential for improving symptoms and enhancing quality of life.

关 键 词：胃食管反流病 膈肌脚 食管下段括约肌 胃食管阀瓣 膈食管筋膜 

分 类 号：R655.4[医药卫生—外科学] R655.6[医药卫生—临床医学]