经腹腔镜改良Heller手术加胃底折叠术治疗贲门失弛缓症

目的:探讨腹腔镜治疗贲门失弛缓症的方法及其优势。方法:经腹腔镜行食管贲门括约肌切开术(改良Heller手术)加胃底折叠术治疗贲门失弛缓症1例。结果:手术顺利,手术时间140m in,术中出血量30m l。患者术后第3天进软食无异常后出院。术后3个月食管下括约肌(LES)残留压、松弛率以及食管基础压均恢复正常,钡餐结果显示为正常食管影像,24h食管pH值测定正常,未见返流。随访6个月,症状无反复。结论:经腹腔镜改良Heller手术加胃底折叠术治疗贲门失弛缓症具有创伤小,术后康复快,疗效确切等优点。

Laparoscopic modified Heller myotomy combined with toupet fundoplication for achalasia

Objective:To explore the technique and advantage of treating achalasia with laparoscopic minimally invasive surgery.Methods:A case with achalasia treated with laparoscopic modified Heller myotomy combined with toupet fundoplication was reported.Results:The operating time was 140min and the blood lose was 30ml.The patient ate soft meal normally and left hospital three days later after operation.After three months the patient's LES residual pressure,percent relaxation and the oesophagus basic pressure came back to normal,barium swallowing and 24 hours pH monitoring were normal.The patient was followed up for 6 months,the preoperative symptoms were disappeared.Conclusions:The laparoscopic modified Heller myotomy combined with toupet fundoplication has an advantage for its minimal invasion,shorter recovery period and assured curative effect.