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1.
T M Farrell W S Richardson T L Trus C D Smith J G Hunter 《The British journal of surgery》2001,88(12):1649-1652
BACKGROUND: Atypical manifestations of gastro-oesophageal reflux (GOR) include asthma, chest pain, cough and hoarseness. The effectiveness of antireflux surgery for these symptoms is uncertain. The present study compared symptomatic response rates for typical and atypical GOR symptoms after fundoplication. METHODS: Between October 1991 and January 1998, 324 patients underwent laparoscopic fundoplication at Emory University Hospital and returned postoperative questionnaires. Severity of typical (heartburn) and atypical (asthma, chest pain, cough and hoarseness) GOR symptoms was reported by patients on a 0-4 scale before surgery, and at 6 and 52 weeks after operation. Patients were stratified based on preoperative symptoms into three groups: group 1 (severe heartburn/minimal atypical symptoms), group 2 (severe heartburn/severe atypical symptoms) and group 3 (minimal heartburn/severe atypical symptoms). RESULTS: In group 1 (n = 173) heartburn improved in 99 per cent and resolved in 87 per cent. In group 2 (n = 95) heartburn improved in 95 per cent and resolved in 76 per cent, and atypical symptoms improved in 94 per cent and resolved in 42 per cent. In group 3 (n = 56) atypical symptoms improved in 93 per cent and resolved in 48 per cent. Although all symptoms were improved by fundoplication, resolution was more likely for heartburn than for atypical symptoms. CONCLUSION: Atypical symptoms of GOR are improved by fundoplication, but symptom resolution occurs in fewer than 50 per cent of patients. 相似文献
2.
《Current surgery》1999,56(7-8):384
Purpose: This study was designed to evaluate symptomatic outcomes following laparoscopic antireflux surgery.Methods: Patients referred for antireflux surgery completed a self-administered 19-question gastrointestinal (GI) survey. The survey evaluates 4 GI symptom complexes: gastroesophageal reflux disease (GERD), abdominal pain, dysphagia and irritable bowel. The GERD symptoms are broken down into GI and respiratory symptoms. Questions are scored on a Likert scale with 0 = no symptoms and 100 = severe symptoms. All patients who had an antireflux procedure and completed pre- and postoperative surveys were included in the study.Results: The 40 patients studied included 21 men and 19 women of mean age 47 ± 15 years. Analysis of pre- and postoperative scores using the paired Student’s t-test was as follows (values expressed as mean ± SEM):
Symptom complex | Preoperative score1 | Postoperative score1 | p Value |
---|---|---|---|
GERD | 54.3 ± 3 | 20.7 ± 4 | <.0001 |
Abdominal pain | 40.7 ± 4 | 21.4 ± 4 | .001 |
Dysphagia | 43.8 ± 6 | 20.0 ± 4 | .002 |
Irritable bowel | 19.1 ± 2 | 19.0 ± 3 | >.97 |