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首页> 外文期刊>Surgical Endoscopy >Antireflux surgery for patients with end-stage lung disease before and after lung transplantation.
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Antireflux surgery for patients with end-stage lung disease before and after lung transplantation.

机译：肺移植前后终末期肺疾病患者的抗回流手术。

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BACKGROUND: Gastroesophageal reflux disease (GERD) is prevalent among patients with end-stage lung disease (ESLD). This disease can lead to microaspiration and may be a risk factor for lung damage before and after transplantation. A fundoplication is the best way to stop reflux, but little is known about the safety of elective antireflux surgery for patients with ESLD. This study aimed to report the safety of laparoscopic fundoplication for patients with ESLD and GERD before or after lung transplantation. METHODS: Between January 1997 and January 2007, 305 patients were listed for lung transplantation, and 189 patients underwent the procedure. In 2003, routine esophageal studies were added to the pretransplantation evaluation. After the authors' initial experience, gastric emptying studies were added as well. RESULTS: A total of 35 patients with GERD or delayed gastric emptying were referred for surgical intervention. A laparoscopic fundoplication was performed for 32 patients (27 total and 5 partial).For three patients, a pyloroplasty also was performed. Two patients had a pyloroplasty without fundoplication. Of the 35 operations, 15 were performed before and 20 after transplantation. Gastric emptying of solids or liquids was delayed in 12 (92%) of 13 posttransplantation studies and 3 (60%) of 5 pretransplantation studies. All operations were completed laparoscopically, and 33 patients recovered uneventfully (94%). The median hospital length of stay was 2 days (range, 1-34 days) for the patients admitted to undergo elective operations. Hospitalization was not prolonged for the three patients who had fundoplications immediately after transplantation. CONCLUSIONS: The results of this study show that laparoscopic antireflux surgery can be performed safely by an experienced multidisciplinary team for selected patients with ESLD before or after lung transplantation, and that gastric emptying is frequently abnormal and should be objectively measured in ESLD patients.
机译：背景：胃食管反流病（GERD）在患有终末期肺病（ESLD）的患者中普遍存在。该疾病可导致微抽吸，并且可能是移植前后肺部损伤的危险因素。胃底折叠术是阻止反流的最佳方法，但对于ESLD患者选择性抗反流手术的安全性知之甚少。本研究旨在报告在肺移植之前或之后，腹腔镜胃底折叠术对ESLD和GERD患者的安全性。方法：在1997年1月至2007年1月之间，列出305例肺移植患者，其中189例接受了手术。 2003年，常规食道研究被添加到了移植前评估中。根据作者的初步经验，还增加了胃排空研究。结果：总共35例GERD或胃排空延迟的患者被转介进行手术干预。对32例患者进行了腹腔镜胃底折叠术（共27例，部分5例）.3例患者也进行了肾盂成形术。两名患者进行了不进行胃底折叠术的肾盂成形术。在35例手术中，有15例在移植前进行，而20例在移植后进行。 13项移植后研究中的12项（92％）和5项移植前研究中的3项（60％）延迟了胃中固体或液体的排空。所有手术均在腹腔镜下完成，其中33例患者恢复良好（94％）。接受择期手术的患者的中位住院时间为2天（范围1-34天）。对于三名移植后立即发生胃底折叠术的患者，住院时间并未延长。结论：这项研究的结果表明，有经验的多学科团队可以对肺移植之前或之后选定的ESLD患者安全地进行腹腔镜抗返流手术，并且胃排空通常是异常的，应客观地对ESLD患者进行测量。

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