在新西兰的腹腔镜抗反流手术:部分眼底复制的趋势。

J A Windsor, S Yellapu
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引用次数: 15

摘要

背景:腹腔镜抗反流手术的出现引起了关于最佳技术的相当大的争论。本研究旨在确定新西兰腹腔镜抗反流手术的趋势和当前技术。方法:在全国范围内向新西兰所有普通外科医生进行保密邮政调查;一个月后再做一次,如果有必要,还会打电话提醒。结果:在发出的146份问卷中,126份被退回(回复率为86%),104份被排除(未进行抗反流手术(n = 96);外科医生退休(n = 5);儿科外科医生(n = 3))。22名(16%)做过腹腔镜抗反流手术的成年普通外科医生的手术数量从1991年到1997年增加了4.6倍(474例开腹手术和1218例腹腔镜手术)。每位外科医生的中位病例数为30例(范围:5-300)。1997年进行了208例(60%)全底重复手术和135例(40%)部分底重复手术。TF技术的变化包括Nissen-DeMeester(10位外科医生)、Nissen-Rosetti(9位外科医生)、胃短血管分割(10位外科医生)和常规结肠成形术(14位外科医生)。一个PF从来没有被6个外科医生做过,被6个外科医生偏爱,另外4个外科医生更常做。PF技术的变化包括后路(12位外科医生)和前路(4位外科医生)形式。结论:新西兰腹腔镜抗反流手术技术差异较大。有16位外科医生倾向于使用TF,但在经验丰富的外科医生中似乎有倾向于使用PF的趋势。
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Laparoscopic anti-reflux surgery in New Zealand: a trend towards partial fundoplication.

Background: The advent of laparoscopic anti-reflux surgery has generated considerable debate regarding the best technique. The present study was undertaken to determine the trends and current technique in laparoscopic anti-reflux surgery in New Zealand.

Methods: A confidential nationwide postal survey was sent to all general surgeons in New Zealand; it was repeated after a month, and followed up with a telephone prompt, if necessary.

Results: Of the 146 questionnaires sent out, 126 were returned (response rate: 86%), and 104 were excluded (no anti-reflux surgery performed (n = 96); surgeon retired (n = 5); paediatric surgeon (n = 3)). The number of operations performed by the 22 (16%) adult general surgeons who had performed laparoscopic anti-reflux surgery increased 4.6 times from 1991 to 1997 (474 open and 1218 laparoscopic operations). The median number of cases per surgeon was 30 (range: 5-300). In 1997 there were 208 (60%) total fundoplications (TF) and 135 (40%) partial fundoplications (PF) performed. Variations in the technique of TF included the Nissen-DeMeester (10 surgeons), the Nissen-Rosetti (nine surgeons), division of short gastric vessels (10 surgeons), and routine cruroplasty (14 surgeons). A PF had never been performed by six surgeons, was preferred by six surgeons, and four other surgeons were performing it more often. Variations in the technique of PF included posterior (12 surgeons) and anterior (four surgeons) forms.

Conclusion: There is significant variation in the technique of laparoscopic anti-reflux surgery in New Zealand. A TF is preferred by 16 surgeons, but there appears to be a trend towards PF among the more experienced surgeons.

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