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首页> 外文期刊>Surgical Endoscopy >Geometry and reproducibility in 360 degrees fundoplication.
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Geometry and reproducibility in 360 degrees fundoplication.

机译：360度胃底折叠术的几何形状和可重复性。

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BACKGROUND: In this study, we set out to precisely define two symmetrical points-a on the anterior fundic wall and b on the posterior fundic wall. These points, when advanced around a 60-Fr bougie-filled esophagus, will meet on the right side, to the right of the anterior vagus nerve, to create a reliable, reproducible, loose (i.e., or "floppy") 360 degrees fundoplication (FP). METHODS: For the terms of this study, circumference = c; diameter = d; c/d = pi; pi = 3.14; and d(cm) = Fr/30. Using a flexible plastic ruler, we measured, in cadavers (n = 5) and intraoperatively (n = 16), esophageal c at the gastroesophageal junction (GEJ) with a 60-Fr bougie in place; d was calculated from c. RESULTS: The smallest measured value for c was 7.5 cm (d = 2.39 cm); the largest value for c was 10.0 cm (d = 3.18 cm). The mean value was 8.35 cm (d = 2.66 cm). Points a and b are established by measuring laterally from a point where the greater curve meets the GEJ in the bougie-filled esophagus. Point a is 6.0 cm laterally and 6.0 cm below the short gastric vessels on the anterior fundus; point b is 6.0 cm laterally in a symmetrical position on the posterior fundus. Connecting these three points as a line defines the inner c of the completed FP and measures 12.0 cm. This gives an internal d of 3.82 cm for the FP. This is >1 cm larger than d for the mean measured external esophageal c of 8.35 cm where d = 2.66 cm. This technique creates a correctly oriented, symmetrical, "floppy," true fundoplication. It avoids wrapping or twisting the fundus around the GEJ. The technique is easily taught and reproducible. CONCLUSIONS: Two points, measured a horizontal distance of 6.0 cm from the GEJ, symmetrically placed on the anterior (point a) and posterior (point b) fundus can be brought anterior (a) and posterior (b) to the esophagus and sutured to the right of the anterior vagus nerve to reliably and reproducibly create a "floppy" 360 degrees fundoplication.
机译：背景：在这项研究中，我们着手精确定义两个对称点-前眼底壁上的a和后眼底壁上的b。当这些点在大约60 Fr的布吉充满食道的食道周围推进时，将在前迷走神经右侧的右侧相遇，从而形成可靠的，可再现的，松散的（即“松散的”）360度胃底折叠术（FP）。方法：对于本研究而言，周长= c;直径= d; c / d = pi; pi = 3.14; d（cm）= Fr / 30。我们使用挠性塑料尺，在尸体（n = 5）和术中（n = 16）中，在胃食管连接处（GEJ）测量了食管c的位置，并放置了60Fr的布吉。 d由c计算。结果：c的最小测量值为7.5 cm（d = 2.39 cm）。 c的最大值为10.0厘米（d = 3.18厘米）。平均值为8.35cm（d ＝ 2.66cm）。 a和b点是通过从较大曲线与布吉食管中的GEJ交汇处横向测量而建立的。 a点位于侧面6.0 cm，位于前眼底短胃血管下方6.0 cm; b点在后眼底的对称位置横向为6.0 cm。将这三个点连接成一条线，定义完成的FP的内部c，尺寸为12.0 cm。 FP的内部d为3.82厘米。对于平均测得的8.35 cm的外部食道c，d大于d 1 cm，其中d = 2.66 cm。此技术可创建正确定向的对称“松散”真正的胃底折叠术。它避免了将眼底包裹或缠绕在GEJ周围。该技术易于教授且可重现。结论：可以将两个点（距GEJ的水平距离为6.0厘米）对称地放置在食道的前（a）和后（b）眼底并缝合至食道的前侧（a点）和后侧（b点）。迷走神经的右端能够可靠且可重复地产生“松散的” 360度胃底折叠术。

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