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首页> 外文期刊>Surgical Endoscopy >Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice
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Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice

机译：经口无切口胃底折叠术治疗胃食管反流病的临床实践

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Background: Transoral incisionless fundoplication is a recently introduced endoluminal technique for the treatment of gastroesophageal reflux disease (GERD). The objective of this study was to determine outcomes in chronic GERD patients who were referred for surgical management. Methods: A cohort of 38 patients underwent transoral incisionless fundoplication (TIF) in a tertiary care setting. Pre- and post-procedure assessment included GERD-related quality of life questionnaires, proton pump inhibitor (PPI) usage, 24-h pH measurements, upper gastrointestinal endoscopy, esophageal manometry, and registration of adverse events. Duration of follow-up was 36 months. Results: Gastroesophageal valves were constructed of 4 cm (range, 4-6) in length and 220° (range, 180-240) in circumference. One serious adverse event occurred, consisting of intraluminal bleeding at a fastener site. Hiatal hernia was completely reduced in 56 % and esophagitis was cured in 47 % of patients. Postprocedure esophageal acid exposure did not significantly improve (p > 0.05). At 36 (range, 29-41) months follow-up 14 patients (36 %) had undergone revisional laparoscopic fundoplication. Quality of life scores of the remaining cohort showed significant improvement (p < 0.0001) and daily use of antisecretory medication was discontinued by 74 %. Conclusions: Endoluminal fundoplication improved quality of life and reduced the need for PPIs in only a subgroup of patients at 3 years follow-up. The amount of patients requiring additional medication and revisional surgery was high.
机译：背景：经口无切口胃底折叠术是最近引进的腔内技术，用于治疗胃食管反流病（GERD）。这项研究的目的是确定转诊手术的慢性GERD患者的预后。方法：一组38例患者在三级护理中接受了经口无切口胃底折叠术（TIF）。术前和术后评估包括与GERD相关的生活质量问卷，质子泵抑制剂（PPI）使用，24小时pH测量，上消化道内窥镜检查，食管测压和不良事件记录。随访时间为36个月。结果：胃食管瓣长4厘米（范围4-6），周长220°（范围180-240）。发生了一次严重的不良事件，包括紧固件部位的腔内出血。食管裂孔疝完全减少了56％，食管炎得到治愈的患者占47％。术后食管酸暴露没有明显改善（p> 0.05）。在36（29-41）个月的随访中，有14例患者（36％）接受了修订性腹腔镜胃底折叠术。其余队列的生活质量得分显示出显着改善（p <0.0001），并且每天停止使用抗分泌药物的比例为74％。结论：腔内胃底折叠术在3年的随访中仅改善了亚组患者的生活质量，并减少了对PPI的需求。需要额外药物和翻修手术的患者数量很高。

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