生物补片应用于腹腔镜抗反流手术治疗胃食管反流病疗效观察

摘要

目的：评价生物补片应用于腹腔镜抗反流手术治疗胃食管反流病的效果。方法：回顾2012年12月至2014年4月在浙江大学医学院附属邵逸夫医院普外科收治的20例有典型临床症状的胃食管反流病患者，接受腹腔镜食管裂孔修补加360°胃底折叠术，使用4层猪小肠黏膜下层基质补片进行食管裂孔加强修补。结果：20例患者的腹腔镜手术均成功，未发生术中并发症。术后症状均消失，随访3～18个月未复发，有6例患者出现吞咽困难，其中5例经保守治疗好转，1例接受食管下端扩张术。结论：腹腔镜抗反流手术治疗胃食管反流病时，使用4层猪小肠黏膜下层基质补片进行食管裂孔加强修补的效果令人满意。%Objective:To evaluate the application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease ( GERD ).Methods: The clinical data of 20 consecutive GERD patients underwent anti-reflux surgery in Sir Run Run Shaw Hospital from December 2012 to April 2014 were retrospectively analyzed . The laparoscopic hiatal repair with 360 fundoplicaiton was performed and the biological mesh ( Biodesign TM , Surgsis ® ) was implanted for reinforcement of hiatal repair . Results: All laparoscopic procedures were successful , no conversion and no intra-operative complications occurred .The pre-operative complains were relieved in all patients, and no recurrence was observed during 3-18 month of follow-up.Six patients got dysphagia after operation; 5 of them were controlled through medication and psychological induction;1 received esophageal dilatation by bougie .Conclusion: The application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease is satisfactory .