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首页> 外文期刊>Surgical Endoscopy >Resolving gastroesophageal reflux with laparoscopic fundoplication. Findings in 138 cases.
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Resolving gastroesophageal reflux with laparoscopic fundoplication. Findings in 138 cases.

机译：腹腔镜胃底折叠术解决胃食管反流。 138例结果。

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BACKGROUND: The purpose of this study was to evaluate the results of 138 cases of gastroesophageal reflux disease resolved laparoscopically with the Rossetti modification of the Nissen fundoplication and to compare them with findings from other studies in an effort to evaluate the procedure's ability to transfer from an academic setting to a community hospital setting. METHODS: We performed laparoscopic Nissen fundoplication on 138 patients and followed them for up to 45 months. Measures included postoperative reflux persistence, complications, operating time, length of hospital stay, and others. These findings were compared, using the Fisher's exact test, chi-square test, and the two-sample t-test, with results from other studies using open and laparoscopic procedures. RESULTS: No patient undergoing laparoscopic fundoplication experienced gastroesophageal reflux after surgery. Complications, not statistically significantly different from those in other studies, occurred in 15 (10.9%), and conversion to an open procedure was required in two (1.5%). The most common postoperative complaint has been dysphagia (21.7%). Operative time averaged 70.6 min, decreasing from an average of 236 min for the first 10 cases to 40.8 min for the last 10. This measure was statistically significantly lower than all other operative times to which it was compared, except one to which it was almost identical (69.9 min). Length of stay (LOS) averaged 2.3 days, ranging from a low of 7 h to a high of 9 days, which made it fall well within limits set by other studies. Overall, LOS fell from a 3.0-day average for the first 20 cases to a 1.9-day average for the last 20 cases. CONCLUSIONS: Laparoscopic Nissen fundoplication resolved gastroesophageal reflux in all 138 patients, and measures for complications, operating time, and LOS were well within values reported by other studies, indicating the ability of this procedure to be successfully transferred from academic medical centers to the community hospital setting.
机译：背景：这项研究的目的是评估腹腔镜经Nissen胃底折叠术的Rossetti修饰腹腔镜解决的138例胃食管反流疾病的结果，并将其与其他研究结果进行比较，以评估该方法从胃镜转移的能力。学术环境到社区医院环境。方法：我们对138例患者进行了腹腔镜Nissen胃底折叠术，并对其进行了长达45个月的随访。措施包括术后反流持续性，并发症，手术时间，住院时间等。使用Fisher精确检验，卡方检验和两样本t检验对这些发现进行了比较，并与其他使用开放式和腹腔镜手术的研究结果进行了比较。结果：没有患者接受腹腔镜胃底折叠术后出现胃食管反流。 15例（10.9％）发生了并发症，与其他研究无统计学差异。2例（1.5％）需要转换为开放手术。术后最常见的抱怨是吞咽困难（21.7％）。手术时间平均为70.6分钟，从前10例的平均236分钟减少到后10例的40.8分钟。该指标在统计​​学上显着低于与之相比的所有其他手术时间，除了几乎与之相比。相同（69.9分钟）。住院时间（LOS）平均为2.3天，从7小时的低位到9天的高位，这使其完全处于其他研究设定的范围之内。总体而言，LOS从前20例的3.0天平均值下降到后20例的1.9天平均值。结论：腹腔镜尼森胃底折叠术解决了所有138例患者的胃食管反流，并发症，手术时间和LOS的测量值均在其他研究报告的值之内，表明该方法能够成功地从学术医疗中心转移到社区医院设置。

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