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首页> 外文期刊>Surgical Endoscopy >Influence of wrap length on the effectiveness of Nissen and Toupet fundoplications: 5-year results of prospective, randomized study.
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Influence of wrap length on the effectiveness of Nissen and Toupet fundoplications: 5-year results of prospective, randomized study.

机译：包装长度对尼森和张拳青铜有效性的影响：5年性能随机研究结果。

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Long-term results in antireflux surgery may depend on fundoplication type and wrap length. We compared the outcome of two different wrap lengths among the patients undergoing partial or total fundoplications. This study is the next part of a prospective 5-year follow-up assessment.A total of 153 patients were randomized to Nissen or Toupet 1.5- or 3-cm wrap laparoscopic fundoplication. The primary endpoint--treatment failure rate was defined as a recurrent GERD or persistent dysphagia. Intensity of heartburn, dysphagia, gas-bloating, presence of esophagitis were assessed as a secondary outcome at 1-year and 5-year follow-up.At 5-year follow-up, data were collected from 129 (85 %) patients. At 1-year follow-up, 17 (11 %) treatment failures were detected. At the end of the fifth year, the numbers reached 23 (15 %). The failures were more common in the 1.5-cm Toupet (25 %) and the 3-cm Nissen group (18.2 %). The significant difference in failure rates was found between 1.5-cm and 3-cm Toupet groups (P < 0.05). Dysphagia remained low during the follow-up in all of the groups. The prevalence of higher scores of heartburn after 5 years was detected in Nissen 1.5-cm group (20.8 %). The lowest scores were observed in Toupet 3-cm group. Bloating symptoms were more prevalent among Nissen and Toupet 3-cm group patients at 5-year follow-up. At the end of the fifth year, the prevalence of esophagitis was lower in Nissen 1.5-cm (19.3 %) and Toupet 3-cm (13.3 %) groups. The highest prevalence of esophagitis-32.4 %-was found in Toupet 1.5-cm group.Nissen and Toupet fundoplication achieved sufficient control of reflux with success rate of 85 % at 5-year follow-up. There were no significant differences in the postoperative dysphagia, esophagitis, and bloating rates. However, the distribution of treatment failures leads us to conclude that 1.5-cm wrap length is insufficient in cases of posterior partial fundoplication.
机译：Anteteflux手术中的长期结果可能取决于基础药用型和包装长度。我们比较了接受部分或总青铜公司的患者两种不同的包裹长度的结果。本研究是前瞻性5年后续评估的下一部分。总共153名患者被随机转移到尼森或柱1.5-或3厘米包裹腹腔镜技术。主要终点 - 治疗失败率定义为复发性GERD或持久性吞咽困难。患有胃灼热的强度，吞咽困难，气腹，食管炎的存在作为1年和5年的次要结果评估为期5年的随访，从129名（85％）患者中收集数据。在1年的随访中，检测到17（11％）治疗失败。在第五年结束时，数字达到23（15％）。在1.5厘米的键（25％）和3厘米尼森组（18.2％）中，失败更常见。失效率的显着差异在1.5厘米和3厘米的张力组（P <0.05）之间。在所有团体的后续行动期间，吞咽困难仍然很低。在NISSEN 1.5厘米的组（20.8％）中检测到5年后患者患者更高分数的患病率。在Toupet 3-cm组中观察到最低分数。在5年的随访中，尼森和张拳3厘米患者中胀气症状更为普遍。在第五年结束时，Nissen 1.5厘米（19.3％）和张拳3厘米（13.3％）组的食管炎的患病率降低。在张拳1.5厘米Group.Nissen和Toupet Fooglical中发现的食管炎-32.4％的最高流行率为5年后的回流达到了足够的控制权。术后吞咽困难，食管炎和膨胀率没有显着差异。然而，治疗失败的分布导致我们得出结论，在后部基础上的情况下，在后部基础上的情况下不足。

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