腹腔镜海勒-图佩特手术治疗贲门失弛缓症的效果

Dang Hung Nguyen, Duc Huan Pham, Hoang Nguyen
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摘要

研究目的本研究旨在评估腹腔镜 Heller-Toupet 手术治疗贲门失弛缓症的效果。研究方法:这是一项回顾性病例系列研究,于2015年1月至2022年8月期间在河内医科大学附属医院胃肠科实施,包括71名接受腹腔镜Heller-Toupet手术的贲门失弛缓症患者。研究结果52.1%的患者为男性(47.9%多于女性)。平均年龄为(44.9±13.9)岁。吞咽困难发生率为 100%。大多数患者的食管扩张程度为 II 级(76.1%),疾病严重程度为 I 级(57.7%)。平均肌肉开口长度为(7.4±1.3)厘米,手术时间为(135±25)分钟。无转归,术中术后无不良反应。长期疗效:良好(无或极轻度吞咽困难)占90.1%,中度(中度吞咽困难)占9.9%,反流综合征的临床发生率为17%。没有需要干预或再次手术的病例。结论腹腔镜海勒-图佩特术是一种安全、术中和术后并发症发生率低、长期疗效好的贲门失弛缓症治疗方法。
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Results of laparoscopic Heller-Toupet operation for achalasia
Objectives: This study was carried out to evaluate surgical outcomes of laparoscopic Heller-Toupet surgery for achalasia. Methodology: This is a retrospective case series implemented at the Gastrointestinal Department, Hanoi Medical University Hospital between January 2015 and August 2022, including 71 patients with achalasia who underwent laparoscopic Heller-Toupet. Results: 52.1% of patients in the study are male (more than female 47.9%). The average age of the cohort was 44.9±13.9 years. The incidence of dysphagia was 100%. Most patients report esophageal dilatation grade II (76.1%) and disease severity stage I (57.7%). The mean muscle opening length was 7.4±1.3 cm, the operative time was 135±25 minutes. There was no conversion, no intra-and postoperative adverse events. Long-term outcomes: good (no or very mild dysphagia) was 90.1%, moderate (moderate dysphagia) was 9.9% and clinical incidence of reflux syndrome was 17%. There was no case requiring intervention or re-operation. Conclusions: Laparoscopic Heller-Toupet is a safe, low rate of intra- and postoperative complication, and brings good long-term outcomes in the treatment of achalasia.
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