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首页> 外文期刊>Surgical Endoscopy >Does laparoscopic antireflux surgery prevent the occurrence of transient lower esophageal sphincter relaxation?
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Does laparoscopic antireflux surgery prevent the occurrence of transient lower esophageal sphincter relaxation?

机译：腹腔镜抗反流手术是否可以预防食管下括约肌短暂性松弛的发生？

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BACKGROUND: Transient lower esophageal sphincter relaxation (TLESR) is the most common mechanism underlying gastroesophageal reflux disease (GERD), causing 70% to 100% of the reflux episodes in normal subjects and 63% to 74% of the reflux episodes in patients with reflux disease. This study aimed to evaluate the effect of laparoscopic Nissen fundoplication on TLESR in patients with proven GERD. METHODS: We prospectively followed 73 consecutive patients (13 men and 60 women; mean age, 43.7 +/- 1.72 years) with proven diagnosis of GERD and reported TLESRs found during a 40-min esophageal manometric study. These patients had repeat testing 6 months after undergoing laparoscopic Nissen fundoplication. RESULTS: Laparoscopic Nissen fundoplication increased the basal and nadir lower esophageal sphincter (LES) pressure and significantly reduced the number of TLESRs during the manometric study. No patients after surgery exhibited TLESR with nadir less than 2 mmHg. However, 8 of the 73 patients (11%) exhibited TLESR to a nadir exceeding 50% of basal pressure (mean nadir, 5.0 +/- 1.07 mmHg). CONCLUSIONS: The number of TLESRs is reduced significantly by antireflux surgery. Even accounting for increased basal and nadir pressures, the incidence of TLESR is reduced, suggesting that there may be additional mechanisms involved in this process.
机译：背景：短暂性食管下括约肌松弛（TLESR）是胃食管反流病（GERD）的最常见机制，在正常受试者中引起70％至100％的反流发作，在反流患者中引起63％至74％的反流发作疾病。这项研究旨在评估腹腔镜Nissen胃底折叠术对GERD患者的TLESR的影响。方法：我们对40例食管测压研究中确诊为GERD并报告TLESR的73例连续患者（13例男性和60例女性，平均年龄43.7 +/- 1.72岁）进行了随访。这些患者在接受腹腔镜Nissen胃底折叠术6个月后进行了重复测试。结果：腹腔镜尼森胃底折叠术增加了食管测压研究中基底和最低点食管括约肌的压力，并显着减少了TLESR的数量。手术后没有患者出现最低点低于2 mmHg的TLESR。然而，在73名患者中，有8名（11％）表现出TLESR的最低点超过了基础压力的50％（平均最低点为5.0 +/- 1.07 mmHg）。结论：抗反流手术可显着减少TLESR的数量。即使考虑到增加的基础压力和最低压力，TLESR的发生率也会降低，这表明该过程可能涉及其他机制。

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