• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia. Assessment in relation to morphologic type.
【24h】

Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia. Assessment in relation to morphologic type.

机译：腹腔镜Heller肌切开术和Dor胃底折叠术治疗门失弛缓症。有关形态类型的评估。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: The significance of laparoscopic Heller myotomy and Dor fundoplication (LHD) for the treatment of achalasia in relation to the severity of the lesion has not been sufficiently assessed. METHODS: Of patients who were diagnosed with achalasia from August 1994 to February 2004, 55 individuals who underwent LHD served as subjects. The therapeutic effects of LHD were assessed in terms of operation time, intraoperative complications, postoperative hospital stay, and symptom improvement in relation to morphologic type (spindle type, Sp; flask type, Fk; and sigmoid type, Sig). Degree of symptomatic improvement was classified into four grades: excellent, good, fair, and poor. RESULTS: Breakdown of morphologic type was as follows: Sp, n = 29; Fk, n = 18; and Sig, n = 8. Excluding one patient for whom conversion to open surgery was required, median average operation time for 54 patients was 160 min. As to intraoperative complications, esophageal mucosal perforation was seen in nine of the 55 patients (16%); however, conversion to open surgery could be avoided by suturing the affected area. Moreover, intraoperative bleeding of at least 100 g was seen in five of the 55 patients (9%), with one Fk patient requiring conversion to open surgery and transfusion. Median postoperative hospital stay was 8 days. Degree of dysphagia relief was excellent in 45 patients (83%), good in eight patients (15%), and fair in one patient (2%). Excellent improvement was obtained in 90%, 88%, and 50% in Sp, Fk, and Sig patients, respectively. Reflux esophagitis was seen in two patients, and was treated with a proton pump inhibitor. CONCLUSIONS: The results of the present study suggest that classification of morphologic type is a useful parameter in predicting postoperative outcome in achalasia. In order to achieve excellent symptomatic relief, surgery for achalasia should be recommended for but not limited to Sp and Fk types.
机译：背景：腹腔镜Heller肌切开术和Dor胃底折叠术（LHD）在治疗与疾病严重程度有关的门失弛缓症方面的重要性尚未得到充分评估。方法：在1994年8月至2004年2月被诊断患有门失弛缓症的患者中，有55名接受LHD治疗的患者作为研究对象。根据手术时间，术中并发症，术后住院时间以及与形态学类型（纺锤型，Sp;烧瓶型，Fk;和乙状结肠型，Sig）有关的症状改善，评估了LHD的治疗效果。症状改善的程度分为四个等级：优异，良好，一般和较差。结果：形态类型的分解如下：Sp，n = 29。 Fk，n = 18; Sig，n =8。除需要转换为开放手术的一名患者外，54名患者的平均平均手术时间为160分钟。至于术中并发症，在55例患者中有9例（16％）出现了食管粘膜穿孔。但是，通过缝合患处可以避免改用开放手术。此外，在55名患者中有5名（9％）发现术中出血至少100 g，其中一名Fk患者需要转换为开放手术和输血。术后中位住院时间为8天。吞咽困难缓解程度在45例患者（83％）中极好，在8例患者（15％）中良好，在1例患者中（2％）良好。 Sp，Fk和Sig患者分别获得90％，88％和50％的优异改善。两名患者出现反流性食管炎，并用质子泵抑制剂治疗。结论：本研究结果表明形态学类型的分类是预测predict门失弛缓症术后预后的有用参数。为了获得出色的症状缓解，应该建议针对但不限于Sp和Fk类型的门失弛缓症进行手术。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号