Dor胃底折叠术治疗袖状胃切除术后并发胃食管反流病的疗效分析
Therapeutic effect of Dor gastric fundus folding surgery on gastroesophageal reflux disease after sleeve gastrectomy
黄恩民 1侯泽辉 1马宁 1陈双 1周太成1
作者信息
- 1. 中山大学附属第六医院疝和腹壁外科,广州 510655
- 折叠
摘要
目的 探讨Dor胃底折叠术治疗腹腔镜袖状胃切除术(LSG)后并发胃食管反流病(GERD)的疗效和安全性.方法 回顾性分析2021年10月至2023年10月行腹腔镜Dor胃底折叠术11例患者的临床资料,该组患者此前因肥胖及相关代谢疾病接受过LSG手术后并发GERD.分析GerdQ量表评分、胃镜、上消化道X线造影和胃窗彩色多普勒超声检查结果,以及术中和术后并发症.结果 11例患者的手术均获成功.10例患者在修补了食管裂孔以后使用生物补片或合成防粘连补片加强膈肌脚,平均手术时间为(120±31)min,平均术后住院时间为(9±3)d.术后6个月随访显示GERD症状完全缓解10例.术中1例患者发生肝左静脉和食管损伤.术后并发症包括1例肠梗阻和1例吞咽困难,1例患者GERD症状未见改善.仅有1例患者因吞咽困难再次入院行介入引导下食管球囊扩张术.结论 腹腔镜Dor胃底折叠术作为LSG术后GERD的修正手术安全有效,能显著缓解GERD症状.
Abstract
Objective To explore the efficacy and safety of laparoscopic Dor fundoplication in treating gastroesophageal reflux disease(GERD)after laparoscopic sleeve gastrectomy(LSG).Methods A retrospective analysis was conducted on 11 patients undergoing laparoscopic Dor fundoplication between Oct 2021 and Oct 2023.These patients had previously undergone LSG due to obesity and related metabolic diseases and developed GERD postoperatively.The GerdQ scale scores,results of endoscopy,upper gastrointestinal radiography,and gastric window color Doppler ultrasonography were analyzed.Result Surgeries were successfully performed in these 11 patients.After esophageal hiatus repair,10 patients underwent reinforcement of the diaphragmatic crus using biological or synthetic anti-adhesion patches.The average operative time was(120±31)minutes,and the average postoperative hospital stay was(9±3)days.Follow-up at 6 months revealed complete resolution of GERD symptoms in 10 patients.Intraoperatively one patient sustained injuries to the left hepatic vein and esophagus.Postoperative complications included one case of intestinal obstruction and one case of dysphagia,one patient failed to get experience improvement in GERD symptoms.All complications were managed successfully except for one needing re-admission for interventional esophageal balloon dilation due to dysphagia.Conclusion Laparoscopic Dor fundoplication serves as a safe and effective revision surgery for GERD following LSG.
关键词
胃食管反流/胃底折叠术/胃切除术/手术后并发症Key words
Gastroesophageal feflux/Fundoplication/Gastrectomy/Postoperative complications引用本文复制引用
出版年
2024
NETL
NSTL
万方数据