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首页> 外文期刊>Surgical Endoscopy >Laparoscopic esophagomyotomy for achalasia.
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Laparoscopic esophagomyotomy for achalasia.

机译：腹腔镜食管肌切开术治疗门失弛缓症。

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摘要

Results of an ongoing clinical study treating achalasia patients with a transabdominal laparoscopic Heller myotomy and Toupet partial fundoplication are presented. Twelve patients underwent surgery between January 1992 and October 1993. All patients had barium esophagograms, preoperative endoscopy, esophageal manometry, 24-h pH studies, and extensive GI history preoperatively. Surgical complications included two perforations of the mucosa at the gastroesophageal junction repaired laparoscopically. There were no surgical mortalities and the average hospital stay was 39 h. Postoperatively all patients at follow-up had a repeat GI history, esophagogastroscopy, 24-h pH testing, and esophageal manometry. This follow-up showed good-to-excellent relief of dysphagia in all 12 patients with one patient complaining of heartburn documented to be from reflux postoperatively. Manometry showed a mean decrease in the lower esophageal sphincter pressure from 33.4 mmHg preoperatively to 19.3 mmHg postoperatively; 24-hour pH testing showed no significant reflux in the nine patients who had Heller myotomy plus a Toupet fundoplication. However, two of three patients who had Heller myotomy alone demonstrated abnormal 24-h pH testing. One of these patients was symptomatic and was found to have mild esophagitis by biopsy on postoperative endoscopy. These good results have persisted for mean follow-up of 16 months.
机译：介绍了一项正在进行的临床研究的结果，该研究通过腹腔镜Heller肌切开术和Toupet部分胃底折叠术治疗失弛缓症患者。在1992年1月至1993年10月之间，有12例患者接受了手术。所有患者均进行了钡剂食道造影，术前内窥镜检查，食管测压，24小时pH研究以及术前广泛的胃肠道病史。手术并发症包括腹腔镜修复的胃食管连接处粘膜的两个穿孔。没有手术死亡，平均住院时间为39小时。术后所有随访患者均重复胃肠道史，食管胃镜检查，24小时pH测试和食管测压。该随访结果显示，在所有12例患者中，吞咽困难均得到了很好的缓解，其中一名患者抱怨胃灼热是由术后反流引起的。测压法显示食管下括约肌平均压力从术前的33.4 mmHg降低到术后的19.3 mmHg。 24小时的pH测试显示，在9名进行了Heller肌切开术和Toupet胃底折叠术的患者中，没有明显的反流。但是，仅进行Heller肌切开术的三分之二的患者表现出异常的24小时pH测试。其中一名患者是有症状的，经术后内镜检查活检发现为轻度食管炎。这些良好的结果持续了16个月的平均随访。

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