腹腔镜下Heller肌层切开术联合Dor胃底折叠术在贲门失弛缓症患者中的疗效分析
Laparoscopic Heller myotomy combined with Dor fundoplication for the treatment of achalasia of cardia
竺志豪 1毛金磊 1赵飞 2王知非3
作者信息
- 1. 浙江中医药大学第二临床医学院,杭州 310000
- 2. 浙江省人民医院消化内科,杭州 310014
- 3. 浙江省人民医院疝与腹壁外科胃食管反流病中心,杭州 310014
- 折叠
摘要
目的 探讨腹腔镜下Heller层切开术联合Dor胃底折叠术治疗贲门失弛缓症的效果.方法 回顾性分析2020年3月到2023年3月浙江省人民医院8例手术治疗的贲门失弛缓症患者的临床资料,其中男5例,女3例,平均年龄(47±15)岁.结果 吞咽困难是本组患者术前最常见的症状,其次是反酸.8例患者术前均进行胃镜检查及食管高分辨率测压,完善消化道钡餐X线造影、超声内镜、胸部、腹部、食管CT等检查.所有患者均进行腹腔镜下Heller肌层切开术+Dor胃底折叠术,术中食管黏膜损伤2例,即时进行黏膜修补,术后平均住院时间(4.38±2.23)d.术后1个月内发生吞咽困难2例,经保守治疗后出院.所有患者手术后Eckardt评分较术前明显降低(P=0.011).结论 腹腔镜Heller肌层切开术联合Dor胃底折叠手术在治疗贲门失弛缓症患者中具有较好的短～中期疗效.
Abstract
Objective To summarize the experience using laparoscopic Heller myotomy combined with Dor fundoplication for the treatment of achalasia of cardia.Methods This is a retrospective analysis.From Mar 2020 to Mar 2023 8 patients admitted at Zhejiang Provincial People's Hospital were treated surgically,including 5 males and 3 females with a mean age of(47±15)years.Results Dysphagia was the most common preoperative symptom,followed by acid reflux.All patients underwent preoperative gastroscopy and esophageal high-resolution manometry.Most patients underwent gastrointestinal barium series,ultrasound endoscopy,and chest/abdomen/esophageal CT.All patients underwent laparoscopic Heller myotomy+Dor fundoplication,2 cases suffered from intraoperative esophageal mucosal injury,and received intraoperative mucosal repair.Mean postoperative hospital stay was(4.38±2.23)days,and 2 cases complaining dysphagia within 1 month after surgery,treated conservatively recovered and discharged.The Eckardt score was significantly lower in all patients after surgery than before surgery(P=0.011).Conclusion Laparoscopic Heller myotomy combined with Dor fundoplication has good short and medium-term efficacy in the treatment of patients with achalasia of the cardia.
关键词
胃底折叠术/贲门失弛缓症/腹腔镜Key words
Fundoplication/Achalasia of Cardia/Laparoscopy引用本文复制引用
基金项目
浙江省卫生健康委临床研究应用项目(2022KY054)
出版年
2024
NETL
NSTL
万方数据