2010-2021 年间哈萨克斯坦共和国开放式与腹腔镜尼森氏胃底折叠术的临床效果和复发率。

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Iranian Journal of Medical Sciences Pub Date : 2024-01-01 DOI:10.30476/IJMS.2023.96685.2839
Bolatbek Baimakhanov, Shakir Zhurayev, Adil Shokebaev, Nurbol Orynbassar, Nurmakhan Imammyrzayev, Khozybek Kazakhstan, Kuanysh Kanatov, Yevgene Yenin, Gulziya Ismailova
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引用次数: 0

摘要

背景:复发性胃食管反流病(GERD)的手术治疗会对患者的生活质量(QoL)产生负面影响。在考虑手术治疗时,确定风险因素至关重要。本研究旨在评估腹腔镜下初次尼森胃底折叠术(LNF)和开腹尼森胃底折叠术(ONF)的短期和长期疗效,以及腹腔镜下再次胃底折叠术的风险:2010年至2021年,国家外科研究中心(哈萨克斯坦阿拉木图)开展了一项回顾性队列观察研究。根据原发性胃食管反流手术矫正的类型,475名患者被分为两组,即LNF组(117人)和ONF组(358人)。对LNF和ONF手术的结果和相关并发症进行了评估。分析了危险因素导致胃食管反流病复发的几率以及干预后的生活质量:结果:ONF手术的术后并发症是LNF的2.7倍(P=0.0001)。此外,ONF手术的术中并发症(7.7%)高于LNF(1.4%)(P=0.002)。在临床表现持续存在的病例中,初次 LNF 和 ONF 手术失败后重新进行胃底折叠术的比例相同。肥胖(OR=2.16,P=0.473)和男性(OR=3.0,P=0.272)是导致再次胃底折叠术的复发性胃食管反流病的相关风险因素。胃底折叠术后一年,88.7%的患者对手术效果表示满意:结论:胃食管反流病的复发症状和再次胃底折叠术的比例与肥胖和男性有关。肥胖是主要的风险因素,因此必须严格选择患者进行手术治疗。
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Clinical Outcome and Recurrence of Open versus Laparoscopic Nissen Fundoplication in the Republic of Kazakhstan during 2010-2021.

Background: Surgical treatment of recurrent gastroesophageal reflux disease (GERD) negatively affects patients' quality of life (QoL). Determination of risk factors is essential when considering a surgical approach. The present study aimed to evaluate short-term and long-term outcomes of primary laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF), as well as the risks of laparoscopic redo fundoplication.

Methods: A retrospective cohort observational study was conducted from 2010 to 2021 at the National Research Center of Surgery (Almaty, Kazakhstan). Depending on the type of primary GERD surgical correction, 475 patients were stratified into two groups, namely LNF (n=117) and ONF (n=358). The outcomes and associated complications of LNF and ONF surgeries were assessed. The odds ratio of recurrent GERD in terms of risk factors was analyzed as well as post-intervention QoL.

Results: Postoperative complications in ONF surgery were 2.7-fold higher than in LNF (P=0.0001). Moreover, intra-operative complications were higher with ONF surgery (7.7%) than with LNF (1.4%) (P=0.002). In cases with persistent clinical manifestations, the rate of redo fundoplication was the same after failed primary LNF and ONF. The risk factors associated with recurrent GERD, leading to redo fundoplication, were obesity (OR=2.16, P=0.473) and male sex (OR=3.0, P=0.272). One-year after LNF, 88.7% of the patients were satisfied with the outcome of the surgery.

Conclusion: Recurrent symptoms of GERD and the rate of redo fundoplication were associated with obesity and the male sex. Obesity was the main risk factor, necessitating stringent selection of patients for surgical management of the disease.

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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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