腹腔镜Roux-en-Y改道术治疗胃食管术后顽固性胃食管反流的初步经验

目的:探讨腹腔镜Roux-en-Y改道术治疗治疗胃食管术后顽固性胃食管反流及其呼吸道症状的方法与疗效.方法:分析腹腔镜Roux-en-Y空肠改道术治疗5例此类患者的手术史、临床表现、Roux-en-Y改道方法和随访12～22个月的疗效.结果:所有的患者均行40 cm空肠的Roux-en-Y改道术,无手术死亡和术后并发症.4例患者反流症状和呼吸道症状消失,1例患者症状明显改善,所有患者均停用抗反流药物.结论:腹腔镜Roux-en-Y空肠改道术可有效控制食管切除或胃大部切除手术后的顽固性反流及由其引起的消化和呼吸道症状.

Laparoscopic Roux-en-Y diversion for intractable gastroesophageal reflux after gastroesophageal procedures

Objective: To investigate the methods and efficacy of laparoscopic Roux-en-Y diversion for intractable gastroesophageal reflux and respiratory symptoms following gastroesophageal surgery. Methods: The data from 5 patients with this disorder, which included the surgical history, clinical manifestations and Roux-en-Y diversion procedures as well as the results during the follow-up period of 12 to 22 months, were studied. Results: All the patients underwent a 40-cm jejunal Roux-en-Y diversion, and no operative death or postoperative complications occurred. The reflux and respiratory symptoms were completely relieved in 4 patients, and were significantly improved in one patient. Use of antireflux drugs was discontinued in all patients. Conclusion: Laparoscopic Roux-en-Y diversion can effectively correct the intractable gastroesophageal reflux and associated digestive and respiratory symptoms following esophagectomy or subtotal gastrectomy.