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首页> 外文期刊>Surgical Endoscopy >Histologic and clinical outcome after laparoscopic Nissen fundoplication for gastroesophageal reflux disease and Barrett's esophagus.
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Histologic and clinical outcome after laparoscopic Nissen fundoplication for gastroesophageal reflux disease and Barrett's esophagus.

机译：腹腔镜尼森胃底折叠术治疗胃食管反流病和巴雷特食管后的组织学和临床结局。

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BACKGROUND: The effectiveness of laparoscopic Nissen fundoplication for the regression of Barrett's esophagus in gastroesophageal reflux disease remains controversial. The aim of this study, therefore, was to review endoscopic findings and clinical changes after laparoscopic Nissen fundoplication for gastroesophageal reflux disease, particularly for patients with Barrett's esophagus. METHODS: From September 1995 through June 2004, 127 patients with gastroesophageal reflux disease underwent laparoscopic Nissen fundoplication. All the patients had clinical and endoscopic follow-up evaluation. We further analyzed the course of 37 consecutive patients with Barrett's esophagus (29% of all laparoscopic fundoplications performed in our institution) using endoscopic surveillance with appropriate biopsies and histologic evaluation. The median follow-up period for all the patients after fundoplication was 34 months (range, 3-108 months). The median follow-up period for the patients with Barrett's esophagus was 19 months (range, 3-76 months). RESULTS: During the 9-year period, 70 women (55 %) and 57 (45%) men were treated with laparoscopic Nissen fundoplication. The median age of these patients was 42 years (range, 7-81 years). The clinical results were considered excellent for 67 patients (53%), good for 51 patients (40%), fair for 7 patients (6%), and poor for 2 patients (1%). Endoscopic surveillance showed regression of the macroscopic columnar segment in 23 patients with Barrett's esophagus (62%). Regression at a histopathologic level occurred for 15 patients (40%). The histopathology remained unchanged for 14 patients with Barrett's esophagus (38%). CONCLUSION: Laparoscopic Nissen fundoplication effectively controls intestinal metaplasia and clinical symptoms in the majority of patients with Barrett's esophagus.
机译：背景：腹腔镜尼森胃底折叠术对胃食管反流病中巴雷特食管消退的有效性仍存在争议。因此，本研究的目的是回顾腹腔镜尼森胃底折叠术对胃食管反流疾病，特别是对于Barrett食道患者的内镜检查结果和临床变化。方法：自1995年9月至2004年6月，对127例胃食管反流病患者进行了腹腔镜Nissen胃底折叠术。所有患者均经过临床和内镜随访评估。我们使用适当的活组织检查和组织学评估方法进一步分析了连续37例Barrett食管患者的病程（在我们机构中进行的所有腹腔镜胃底折叠术的29％）。胃底折叠术后所有患者的中位随访期为34个月（范围3-108个月）。巴雷特食管患者的中位随访期为19个月（范围3-76个月）。结果：在这9年中，接受腹腔镜Nissen胃底折叠术治疗了70名女性（55％）和57名（45％）男性。这些患者的中位年龄为42岁（范围7-81岁）。临床结果被认为对67例患者（53％）极好，对51例患者（40％）良好，对7例患者（6％）中等，对2例患者差（1％）。内窥镜检查显示23例Barrett食管患者的宏观柱状节段消退（62％）。 15例患者（40％）在组织病理学水平上出现了退变。 14例Barrett食管患者（38％）的组织病理学保持不变。结论：腹腔镜尼森胃底折叠术可有效控制大多数Barrett食道患者的肠上皮化生和临床症状。

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