摘要
目的探讨达芬奇机器人辅助Nissen胃底折叠术治疗难治性胃食管反流病(rGERD)的近期效果,评价其手术治疗安全性及有效性。方法回顾性分析我院2016年10月至2019年11月行达芬奇机器人辅助手术治疗rGERD患者40例的临床资料,其中男23例、女17例,年龄34~76(61±23)岁。结果全组患者均无围手术期死亡,无食管胃底瘘等严重并发症。术后反流症状均明显改善,患者术前术后DeMeester评分[(39.79±35.01)分vs.(2.61±2.40)分,P=0.029]、食管下括约肌压力[(8.74±7.21)mm Hg vs.(24.56±8.76)mm Hg,P=0.020]、完整松弛压力[(7.29±7.21)mm Hg vs.(16.49±9.99)mm Hg,P=0.023]、食管远端收缩积分平均值[(600.49±665.30)mm Hg·s·m vs.(510.99±580.60)mm Hg·s·m,P=0.042]、GERD-Q量表评分[(12.98±2.39)分vs.(7.59±1.11)分,P=0.033],均较术前有明显改善。术后出现2例吞咽困难,经过饮食调整等处理后均症状缓解。结论达芬奇机器人辅助Nissen折叠术是治疗rGERD安全有效可行。
Objective To investigate the short-term effects of Da Vinci robot-assisted Nissen fundoplication in the treatment of refractory gastroesophageal reflux disease(rGERD),and to evaluate the safety and efficacy of its surgical treatment.Methods A total of 40 patients with rGERD treated by Da Vinci robot-assisted surgery from October 2016 to November 2019 in our hospital were collected.There were 23 males and 17 females at age of 34-76(61±23)years.The related clinical data were retrospectively analyzed,and the operation skills of Da Vinci robot-assisted Nissen fundoplication with rGERD were summarized.Results There was no perioperative death or serious complication such as esophagogastric fistula.Postoperative reflux symptoms were significantly improved.DeMeester scores after surgery(39.79±35.01 points vs.2.61±2.40 points,P=0.029),lower esophageal sphincter pressure(8.74±7.21 mm Hg vs.24.56±8.76 mm Hg,P=0.020),integrated relaxation pressure(7.29±7.21 mm Hg vs.16.49±9.99 mm Hg,P=0.023),distal contractile integral(600.49±665.30 mm Hg·s·m vs.510.99±580.60 mm Hg·s·m,P=0.042),GERD-Q scale score(12.98±2.39 points vs.7.59±1.11 points,P=0.033)were significantly improved compared with those before surgery.Postoperative dysphagia was found in 2 patients.And dysphagia was alleviated after diet adjustment and other treatments.Conclusion Da Vinci robot-assisted Nissen fundoplication is a safe and effective treatment for rGERD.
作者
康珀铭
陶绍霖
谭群友
蒋彬
吴礼成
方春抒
李青元
王如文
KANG Poming;TAO Shaolin;TAN Qunyou;JIANG Bin;WU Licheng;FANG Chunshu;LI Qingyuan;WANG Ruwen(Department of Thoracic Surgery,Daping Hospital,Army Medical University,Chongqing,400042,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2020年第3期274-278,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
重庆市技术创新与应用发展专项面上项目(cstc2019jscx-msxmX0252)
