腹腔镜Nissen胃底折叠术治疗胃食管反流病

目的 探讨腹腔镜Nissen胃底折叠术治疗胃食管反流病的效果.方法 对近2年来收治的109例胃食管反流病实施腹腔镜Nissen胃底折叠术患者的临床资料进行回顾性分析.结果 108例成功完成手术.1例因难以控制的脾上极胃短血管出血而中转开腹.手术用时30-245(平均68.1)min,术中出血5～450(平均30.0)mL;术后住院天数2～8(平均4.2)天.术后102例获3～27个月的随访,7例失访.随访患者中99例(97.1%)反酸、烧心等消化道症状基本消失,2例(2.0%)明显缓解,1例(0.9%)无效.术后2例出现较严重的吞咽困难,1例严重上腹胀气,2例腹泻,1例出现术后食管裂孔疝.结论 腹腔镜Nissen胃底折叠术是治疗胃食管反流病的一种微创、安全、有效的治疗方法.

Laparoscopic Nissen fundoplication for treatment of gastroesophageal reflux disease

Objective: To observe the clinical effects and complications of laparoscopic Nissen fundoplication (LNF) in treatment of gastroesophageal reflux disease (GERD).
Methods:  From November 2006 to November 2008, 109 consecutive patients with GERD were treated by LNF. The clinical records of these patients were retrospectively analyzed.
Results: All patients, except one case converted to laparotomy because of bleeding from short gastric vessel.  The mean operation time was 〖JP2〗68.1 min (30-245 min); mean intraoperative blood loss was 30.0 mL (5-450 mL); and mean postoperative hospital stay was 4.2 d(2-8 d).Postoperatively, 102 patients were  followed-up for 3 to 27 months, and among them, 99 patients (97.1%) had complete resolution of their digestive symptoms such as regurgitation and heartburn, 2 patients (2.0%) had symptoms markedly relieved, and 1 patient (0.9%) had not improved. Postoperative complications included severe dysphagia in 2 cases, bloating in 1 case，diarrhea in 2 cases and postoperative hiatal hernia in 1 case.
Conclusions:  Laparoscopic Nissen fundoplication is a minimally-invasive, safe and effective procedure in the treatment of gastroesophageal reflux disease.