胃食管反流病的腹腔镜外科治疗

目的:探讨腹腔镜手术治疗胃食管反流病的临床效果.方法:回顾性分析2008年1月—2011年9月对33例胃食管反流病患者行腹腔镜食管裂孔疝修补和胃底折叠术的临床资料.腹腔镜单纯胃底折叠术5例(Toupet式),腹腔镜食管裂孔疝修补加胃底折叠术25例(Nissen式3例,Toupet式22例),腹腔镜单纯食管裂孔疝修补术3例.结果:全组患者手术均获成功,手术时间90～185 min.术后平均住院6d.无中转开腹及死亡病例,无术后严重并发症.术后随访1～24个月,32例临床症状完全消失,1例明显好转.结论:对于胃食管反流性疾病,腹腔镜食管裂孔疝修补和胃底折叠术是一种微创、安全、有效的治疗方法.

Laparoscopic surgery for treatment of gastroesophageal reflux disease

Objective: To determine the clinical efficacy of laparoscopic surgery for treatment of gastroesophageal refluxdisease (GERD).Methods: The clinical data from 33 patients undergoing laparoscopic repair of esophageal hiatal hernia andlaparoscopic fundoplication from January 2008 to September 2011 were retrospectively analyzed. Of thepatients, laparoscopic fundoplication (Toupét procedure) alone was performed in 5 cases, 25 cases underwentlaparoscopic esophageal hiatal hernia repair plus a fundoplication (3 Nissen procedures and 22 Toupétprocedures) and 3 cases had laparoscopic esophageal hiatal hernia repair alone.Results: The operations were successfully performed in all patients. The operatiive time was from 90 to185 min and the average length of postoperative hospital stay was 6 days. There was no conversion to openprocedure and no death occurred. No severe postoperative complications were observed. The postoperativefollow-up period was from 1 month to 24 months. The symptoms of 32 patients completely disappeared, and 1patient significantly improved.Conclusion: Laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication are minimallyinvasive,safe and effective procedures for gastroesophageal reflux disease.