生物补片应用于腹腔镜抗反流手术治疗胃食管反流病疗效观察

目的:评价生物补片应用于腹腔镜抗反流手术治疗胃食管反流病的效果.方法:回顾2012年12月至2014年4月在浙江大学医学院附属邵逸夫医院普外科收治的20例有典型临床症状的胃食管反流病患者,接受腹腔镜食管裂孔修补加360°胃底折叠术,使用4层猪小肠黏膜下层基质补片进行食管裂孔加强修补.结果:20例患者的腹腔镜手术均成功,未发生术中并发症.术后症状均消失,随访3～18个月未复发,有6例患者出现吞咽困难,其中5例经保守治疗好转,1例接受食管下端扩张术.结论:腹腔镜抗反流手术治疗胃食管反流病时,使用4层猪小肠黏膜下层基质补片进行食管裂孔加强修补的效果令人满意.
Abstract: Objective: To evaluate the application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease (GERD). Methods: The clinical data of 20 consecutive GERD patients underwent anti-reflux surgery in Sir Run Run Shaw Hospital from December 2012 to April 2014 were retrospectively analyzed. The laparoscopic hiatal repair with 360 fundoplicaiton was performed and the biological mesh (BiodesignTM, Surgsis？) was implanted for reinforcement of hiatal repair. Results: All laparoscopic procedures were successful, no conversion and no intra-operative complications occurred. The pre-operative complains were relieved in all patients, and no recurrence was observed during 3-18 month of follow-up. Six patients got dysphagia after operation; 5 of them were controlled through medication and psychological induction; 1 received esophageal dilatation by bougie. Conclusion: The application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease is satisfactory. Key words: Gastroesophageal reflux/surgery Hernia, hiatal/surgery Biocompatible materials Reconstructive surgical procedures Laparoscopy Treatment outcome Retrospective studies Follow-up studies