使用 RefluxStop 进行腹腔镜大疝修补术:30 名患者六个月的随访结果。

Yannick Fringeli, Ioannis Linas, Ulf Kessler, Joerg Zehetner
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引用次数: 0

摘要

目的:使用 RefluxStop 装置的抗反流手术技术是治疗胃食管反流病(GERD)患者的最新方法之一。本研究的目的是评估使用 RefluxStop 设备对胃食管反流病患者进行腹腔镜食管裂孔疝(HH)修补术的安全性和可行性:对首批 30 名同意并使用 RefluxStop 装置进行 HH 手术的大型 HH 患者进行回顾性病历审查。对手术技术和结果进行评估,以评估安全性和可行性、HH 复发率、吞咽困难和患者满意度:2020年5月至2022年4月期间,30名患者接受了使用RefluxStop装置的腹腔镜HH修复手术。所有患者都有胃食管反流病的典型症状,如烧心和反胃,15 名患者(50%)术前有吞咽困难。HH 大小中位数为 5 厘米(四分位间范围为 4 至 5)。手术时间中位数为 56 分钟(四分位间范围为 52 到 63 分钟),术中和术后均未出现与该装置有关的并发症。一名患者因粘连和进入腹部时伴有出血而需要开腹手术。所有患者都在术后第 1 天和 3 个月进行了术后成像(视频透视),确认了 RefluxStop 装置的正确位置。一名患者(3.3%)因严重吞咽困难而需要进行术后球囊扩张。所有患者的反流症状(烧心和胃酸倒流)在 6 个月时都明显缓解(P < 0.001)。随访 6 个月期间,有一次 HH 复发(3.3%):本研究表明,使用 RefluxStop 装置对大型 HH 患者进行腹腔镜 HH 修复术具有短期安全性和可行性,术后吞咽困难发生率低,所有患者的反流症状均得到改善或缓解。
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Laparoscopic Large Hiatal Hernia Repair With RefluxStop: Outcomes of Six Months Follow-up in Thirty Patients.

Objective: The antireflux surgical technique with the RefluxStop device is one of the latest approaches to treating patients with gastroesophageal reflux disease (GERD). The aim of this study was to assess the safety and feasibility of laparoscopic hiatal hernia (HH) repair with the RefluxStop device in patients with GERD and concurrent large HH (≥4 cm).

Patients and methods: A retrospective chart review was performed for the first 30 patients with a large HH who consented and underwent HH surgery with the RefluxStop device. The operative technique and outcomes were evaluated to assess safety and feasibility, HH recurrence, dysphagia, and patient satisfaction.

Results: Between May 2020 and April 2022, 30 patients underwent laparoscopic HH repair with the RefluxStop device. All patients had typical symptoms of GERD, such as heartburn and regurgitation, and 15 patients (50%) had preoperative dysphagia. Median HH size was 5 cm (interquartile range, 4 to 5). Median operating time was 56 minutes (interquartile range, 52 to 63), with no intra and postoperative complications related to the device. One patient required laparotomy due to adhesions and associated bleeding when accessing the abdomen. All patients had postoperative imaging (video fluoroscopy) on postoperative day 1 and at 3 months, confirming the correct location of the RefluxStop device. One patient (3.3%) needed postoperative balloon dilatation due to severe dysphagia. Reflux symptoms (heartburn and acid regurgitation) resolved significantly in all patients ( P < 0.001) at 6 months. One episode of recurrence of HH (3.3%) occurred during the follow-up period of 6 months.

Conclusion: This study demonstrates the short-term safety and feasibility of laparoscopic HH repair with the RefluxStop device in patients with large HH, with a low rate of postoperative dysphagia and subsequent improvement or resolution of reflux symptoms in all patients.

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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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