[Laparoscopic fundoplication--what is proven?].

H J Stein
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引用次数: 0

Abstract

Laparoscopic fundoplication has become a popular procedure but several questions remain unresolved. Although randomised trials suggest that antireflux surgery is a good alternative to continuous medical therapy, the selection of patients for surgery remains crucial to achieve success. There is currently no proof that antireflux surgery will reduce the risk for developing esophageal adenocarcinoma. Complications, side effects and failures appear to be higher after a laparoscopic approach as compared to conventional open surgery, particularly in un-experienced hands. Partial fundoplications and tailored approaches have so far not shown convincingly better results than those that can be achieved by short and floppy 360 fundoplication.

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[腹腔镜下眼底复制术——证明了什么?]
腹腔镜下翻底术已成为一种流行的手术,但仍有几个问题尚未解决。尽管随机试验表明,抗反流手术是持续药物治疗的一个很好的替代方案,但手术患者的选择仍然是取得成功的关键。目前还没有证据表明抗反流手术会降低患食管腺癌的风险。与传统的开放手术相比,腹腔镜手术的并发症、副作用和失败似乎更高,特别是在没有经验的患者中。到目前为止,局部复底和量身定制的方法并没有显示出令人信服的效果,而短而软的360度复底可以取得更好的效果。
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[120th Congress of the German Surgical Society. 29 April-2 May 2003, Munich, Germany. Abstracts]. [Clinical application--suture materials]. [Inguinal hernia: TAPP--future standard?]. [Preservation of the recurrent laryngeal nerve]. [Surgery of euthyroid nodular goiter: special considerations in surgery of recurrent struma].
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