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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01): 51 -54. doi: 10.3877/cma.j.issn.1674-6899.2018.01.014

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腹腔镜Nissen胃底折叠术治疗老年重度胃食管反流病的长期疗效观察
郑明伟 1, 孙向宇 2, 吴瑜 2 , †( ), 陈震 2, 赵宏志 2, 戴其利 2, 郎琳 2   
  1. 1. 300100 天津市南开医院微创外科；300100 天津市南开医院日间手术中心
    2. 300100 天津市南开医院微创外科
  • 收稿日期:2017-12-25 出版日期:2018-02-28
  • 通信作者: 吴瑜

Long-term therapic effect of laparoscopic Nissen fundoplication for elderly patients with severe gastroesophageal reflux disease

Mingwei Zheng 1, Xiangyu Sun 2, Yu Wu 2 , †( ), Zhen Chen 2, Hongzhi Zhao 2, Qili Dai 2, Lin Lang 2   

  1. 1. Department of Minimally-invasive Surgery, Tianjin Nankai Hospital of Tianjin Medical University, Tianjin 300100, China; Department of Ambulatory Surgery Centre, Tianjin Nankai Hospital of Tianjin Medical University, Tianjin 300100, China
    2. Department of Minimally-invasive Surgery, Tianjin Nankai Hospital of Tianjin Medical University, Tianjin 300100, China
  • Received:2017-12-25 Published:2018-02-28
  • Corresponding author: Yu Wu
  • About author:
    Corresponding author: Wu Yu, Email:
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目的

通过对老年重度胃食管反流病(gasroesophageal reflux disease，GERD)患者行腹腔镜Nissen胃底折叠术(laparoscopic Nissen fundoplication，LNF)的长期随访结果和对照组对比分析，评价该方法远期的安全性和有效性。

方法

回顾分析自2005年1月至2011年1月因重度GERD行LNF治疗的老年患者21例，与同期对照组44例对比，分析两组患者的远期治疗效果。

结果

两组患者均成功行LNF治疗，术后早期症状均获得缓解，手术时间和术后短期并发症两组比较无明显差异，术后胃镜见食管炎症状均较术前有所好转。术后平均随访7.4年，两组复发率比较无统计学差异，老年组远期吞咽困难发生率高于对照组。

结论

LNF治疗老年重度GERD安全、有效，但远期吞咽困难发生率较高于对照组。

关键词: 腹腔镜Nissen胃底折叠术, 老年, 胃食管反流病, 远期疗效
Objective

To assess the therapic effect of laparoscopic Nissen fundoplication for elderly patients with severe gastroesophageal reflux disease(GERD) comparing to non-elderly patients.

Methods

Between Jan. 2005 and Jan. 2011, 65 patients admitted our centre for severe GERD and underwent laparoscopic Nissen fundoplication. 21 cases of 65 patients were older than 70 years which were divided into elderly group and the other 44 non-elderly cases were control group. The clinical data about therapies and recovery of two groups was recorded and analyzed retrospectively.

Results

All patients underwent laparoscopic Nissen fundoplication successfully. The clinical symptoms of two groups were relieved postoperatively. The short-term complication rate and mean operative time were no significant difference. The mean follow-up period was 7.4 years. The recurrence rate of two groups was no significant difference, but the postoperative dysphagia rate in elderly group was more than control group.

Conclusions

Laparoscopic Nissen fundoplication is safe and effective for elderly patients with server GERD, but the incidence of long-term dysphasia was higher.

Key words: Laparoscopic Nissen fundoplication, Elderly, Gastroesophageal reflux disease, Long-term outcoming
表1 胃食管反流病行腹腔镜Nissen胃底折叠术治疗的两组手术时间、术后短期并发症和满意度评分对比
组别 例数 手术时间(min， ±s) 术后短期并发症[例(%)] 术后满意度评分(分， ±s)
老年组 21 102.1 ± 28.7 1(4.8) 8.2 ± 2.5
对照组 44 96.0 ± 18.8 3(6.8) 8.4 ± 2.3
P值 ? > 0.05 > 0.05 > 0.05
表2 胃食管反流病行腹腔镜Nissen胃底折叠术治疗的两组术后远期并发症对比[例(%)]
组别 例数 症状复发 吞咽困难
老年组 21 1(4.8) 5(23.8)
对照组 44 3(6.8) 2(4.5)
P值 ? > 0.05 <0.05
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