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首页> 外文期刊>Annals of Surgery >Total or posterior partial fundoplication in the treatment of GERD: results of a randomized trial after 2 decades of follow-up.
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Total or posterior partial fundoplication in the treatment of GERD: results of a randomized trial after 2 decades of follow-up.

机译：GERD治疗的全部或后部部分胃底折叠术：随访20年后的一项随机试验结果。

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OBJECTIVE AND BACKGROUND: We lack long-term data (>10 years) on the efficacy of antireflux surgery when evaluated within the framework of randomized clinical trials Hereby we report the outcome of a randomized trial comparing open total (I) and a Toupet posterior partial fundoplication (II) performed between 1983 and 1991. METHODS: One hundred and thirty-seven patients with gastroesophageal reflux disease and were enrolled into the study. The mean follow up has now reached 18 years. During these years 26% had died and 16% were unable to trace for follow up. Symptom outcomes were assessed by the use of validated self-reporting questionnaires. RESULTS: Long-term control of heartburn and acid regurgitation (reported as no or mild symptoms) were reported by 80% and 82% after a total fundoplication (I) and corresponding figures were 87% and 90% after a partial posterior fundoplication (II), respectively (n.s.).The dysphagia scores were low 4.6 +/- 1.3 (SEM) in group I and 3.3 +/- 0.9 (SEM) in group II (n.s). The point prevalences of rectal flatulence and gas distension related complaints were of similar magnitude in the 2 groups. Twenty-three percentage of the patients in the total fundoplication group noted some ability to vomit compared with 31% in the partial posterior fundoplication group. CONCLUSIONS: Both a total and a partial posterior fundoplication maintain a high level of reflux control after 2 decades of follow up. The previously reported differences in mechanical side effects, in favor of the partial wrap, seemed to disappear over time.
机译：目的和背景：在随机临床试验的框架内进行评估时，我们缺乏抗反流手术疗效的长期数据（> 10年），据此我们报告了一项比较开放总剂量（I）和Toupet后部局部切除的随机试验的结果1983年至1991年进行了胃底折叠术（II）。方法：137例胃食管反流病患者被纳入研究。现在平均随访时间已经达到18年。在这些年中，有26％的人死亡，而16％的人无法追踪。症状结果通过使用经过验证的自我报告调查表进行评估。结果：在完全胃底折叠术（I）后，长期控制的烧心和反酸（报告为无症状或轻度症状）分别为80％和82％，部分后路胃底折叠术（II）后相应的数字为87％和90％第一组吞咽困难评分低4.6 +/- 1.3（SEM），第二组吞咽困难评分低3.3 +/- 0.9（SEM）（ns）。两组的直肠胀气和与气体膨胀相关的主诉患病率相似。在全部胃底折叠术组中，有23％的患者表示有一定的呕吐能力，而部分后路胃底折叠术组为31％。结论：在进行了20年的随访后，全部和部分后路胃底折叠术都保持了较高的反流控制水平。先前报道的机械副作用的差异（有利于部分包裹）似乎随着时间的流逝而消失。

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