腹腔镜180°前胃底折叠术治疗胃食管反流性疾病的长期随访结果

摘要

Objective To evaluate long-term follow-up for laparoscopic anterior 180° partial fundoplication for gastroesophageal refulx disease (GERD).Methods A total of 48 patients had undergone a laparoscopic anterior 180° partial fundoplication from July 2004 to October 2007.Patients were followed up at 3 months,12 months,3 years,5 years by using a structured questionnaire via phone or e-mail which evaluated symptoms of reflux,dysphagia,side-effects,and overall satisfaction with the clinical outcome.Results Follow-up data were collected from 43 patients,ranging from 60 to 98 months.Postoperative heartburn significantly improved in 37 patients.Normal belching was preserved in 40 patients,and 38 patients were able to eat normally.Thirty nine (90.7％) patients reported a good or excellent result (minimal or no symptoms) at the late follow-up.Two patients underwent laparoscopic anterior 180° partial fundoplication again due to acid reflux at the 12th and 38th month respectively.Conclusion At minimum 5 years followup,laparoscopic anterior 180° partial fundoplication for GERD is effective and lasting,and most patients are satisfied with the outcome.%目的 评价腹腔镜180°前胃底折叠术治疗胃食管反流性疾病的远期效果.方法 2004年7月至2007年9月,48例胃食管反流性疾病患者接受腹腔镜180°前胃底折叠术,术后3个月、12个月、3年、5年及之后每年通过电话或邮寄信件以标准化问卷的形式,对其进行随访,评估烧心、吞咽困难等症状以及术后并发症、整体满意度情况.结果 获得43例随访数据,随访时间60～98个月,平均78个月.最近的一次随访结果显示:37例烧心症状消失或偶尔出现,40例患者可正常嗳气,38例患者可以正常进食,39例(90.7％)患者对术后效果满意.2例患者分别于术后12个月和38个月因反酸再次行腹腔镜胃底折叠术手术,效果良好.结论 腹腔镜180°前胃底折叠术治疗胃食管反流性疾病是一种持久有效的术式,大多数患者对术后长期效果满意.