Effect of laparoscopic fundoplication for proton pump inhibitor dependent gastroesophageal reflux disease: a 10-year follow-up report of 160 cases in a single center
10.3760/cma.j.cn113855-20230425-00306
- VernacularTitle:腹腔镜胃底折叠术治疗质子泵抑制剂依赖性胃食管反流病10年疗效：单中心160例报道
- Author:
Zhiwei HU
1
;
Jimin WU
;
Meng LI
;
Jiannan LIU
;
Changrong DENG
;
Xiulan ZHAN
;
Tao JI
;
Feng WANG
;
Shurui TIAN
;
Yu ZHANG
;
Dong CHEN
Author Information
1. 中国人民解放军火箭军特色医学中心胃食管外科，北京 100088
- Keywords:
Gastroesophageal reflux;
Fundoplication;
Proton pump inhibitors;
Hernia, hiatal;
Esophagitis,peptic
- From:
Chinese Journal of General Surgery
2024;39(6):423-429
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the long-term efficacy of laparoscopic fundoplication for proton pump inhibitor dependent gastroesophageal reflux disease (GERD).Method:Clinical data of proton pump inhibitor dependent GERD patients who underwent fundoplication at the Rocket Force Characteristic Medical Center from Jan to Jun 2012 were analyzed, including GERD symptom score, subjective symptom relief rate, PPI discontinuation rate and surgical satisfaction, as well as recurrence and complications.Result:A total of 160 GERD patients were included in this study, with 64% of patients having respiratory symptoms. Nissen and Toupet fundoplication were performed in 43 and 117 cases, respectively, with a follow-up time of (127±3) months. The postoperative GERD symptom scores of the patients were significantly lower than before treatment (all P<0.001); The subjective relief of overall symptoms in the digestive tract and airway problem was 90% (80%, 100%) and 100%, respectively. The PPI discontinuation rate was 86%, and the overall satisfaction rate of the treatment was 92%, and the satisfaction rate of patients with respiratory symptoms was 89%. 7% of patients experienced varying degrees of symptomatic recurrence, 4% of patients re-underwent endoscopic treatment and/or laparoscopic fundoplication due to symptom recurrence. The incidence of long-term postoperative dysphagia, bloating, belching, increased exhaust, abdominal pain, diarrhea, and constipation were 11.3%, 16.9%, 0, 1.3%, 0, 2.5%, and 5.6%, respectively. Conclusions:Laparoscopic fundoplication has good long-term efficacy in the treatment of GERD. A small number of patients may experience postoperative recurrence, as well as complications such as dysphagia and gas-bloat syndrome. Most recurrent patients can achieve good therapeutic effect by redoing endoscopic treatment or redoing surgery.
