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題名 | Laparoscopic Nissen Fundoplication for Reflux Esophagitis: The Initial Experience=以腹腔鏡Nissen氏胃底包覆術治療逆流性食道炎之早期經驗 |
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作者姓名(中文) | 黃銘德; 賴逸儒; 魏柏立; 伍超群; 李威傑; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 33:2 民89.03-04 |
頁次 | 頁66-71 |
分類號 | 416.241 |
關鍵詞 | 腹腔鏡Nissen氏胃底包覆術; 逆流性食道炎; Reflux esophagitis; Laparoscopic Nissen fundoplication; |
語文 | 英文(English) |
中文摘要 | 許多報告指出以腹腔鏡Nissen胃底包覆術治療逆行性食道炎有減低術後疼痛及縮短住院天數的優點。本篇報告以1997年9月至1998年6月,共有27個病人接受腹腔鏡Nissen胃底包覆術,進而評估結果及手術經驗。這27個病人,有22位男性,5位女性,平均年齡55.3歲(20至75歲),且都有逆流性食道炎的症狀,病人在術前都有接受胃鏡上消化道攝影,食道括約肌及24小時食道酸鹼度測定,結果顯示,在胃鏡檢查有25位病人有不同程度的食道炎,其中一位病人有Barrett's食道炎的變化,有14位併有食道裂孔疝氣。平均手術時間為220分鐘(135至370分鐘),病人在術後第二天即可進流質食物,平均住院日數為4.13天。手術後的併發症,2位有氣胸,2位術後潰傷出血,一位有吞嘸困難的症狀。病人追蹤迄今為6-17個月,23病人症狀皆解除,所以腹腔鏡Nissen胃底包覆術是一個安全而有效的手術,且提供逆流性食道炎另一種治療的選擇。 |
英文摘要 | Laparoscopic Nissen fundoplication is an alternative to open fundoplication in treating reflux esophagitis, providing an excellent result with less operative morbidity and a shorter hospital stay. This study was a retrospective review of 27 patients who underwent laparoscopic Nissen fundoplication for reflux esophagitis from September 1997 through July 1998. The purpose of the study was to report our operative technique and our analysis of the results with this procedure. All of the 27 patients, 22 men and 5 women, ranging in age from 20 to 75 years old, had symptomatic gastroesophageal reflux. Preoperative evaluation included upper gastrointestinal endoscopy, a barium upper GI study, esophageal manometry, and 24-hour pH monitoring. Upper GI endoscopy revealed esophagitis in 25 patients (92.6 %), with Barrett's esophagitis in 1 patient and hiatal hernias in 14 patients (51.9%). The mean operation time was 220 minutes (range, 135 to 370 minutes). All patients tolerated a liquid diet on the first postoperative day. The mean hospital stay was 4 days. Perioperative complications occurred in 5 patients (18.5%), including 2 patients with pneumothorax, 2 with UGI bleeding, and 1 with postoperative dysphagia. Follow-up from 6 to 17 months showed complete relief of symptoms in 23 patients (85.2 %). Laparoscopic Nissen fundoplication is a safe and effective procedure for patients with reflux esophagitis. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。