• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献>>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

胃食管反流病外科治疗术式的演变和展望

The evolution and expectation of surgical options for gastroesophageal reflux disease

摘要胃食管反流病的外科手术治疗在国外已开展近70年,在我国尚处于起步阶段。Allison于1951年最早尝试使用外科手段控制反流,但单纯性的食管裂孔修补疗效欠佳。Nissen于1955年开创胃底折叠术,经Rossetti改良减少了游离范围和手术损伤,提升了抗反流疗效,但术后吞咽困难和气体相关并发症高发。Toupet、Dor等提出部分胃底折叠术,Donahue和DeMeester提出"短松"Nissen手术,在一定程度上保留了手术疗效并降低了术后吞咽困难和气体相关并发症发生率,形成了目前三大主流胃底折叠术式。此外,其他医师也对抗反流术式进行了探索,形成了Belsey Mark Ⅳ、Hill、Collis等术式,但由于种种原因上述术式未获得广泛开展。与此同时,手术途径也从传统的开胸开腹,发展到腹腔镜及机器人手术系统辅助,降低了并发症发生率,减少了住院时间。尽管抗反流术式众多,但各种术式各有优缺点,长期疗效不稳定及各种并发症至今仍然是其获得广泛开展的主要障碍,人们仍然在不断探索更好更微创的抗反流手术方法。

更多

abstractsIt has been nearly 70 years since the first attempt of surgical treatment for gastroesophageal reflux disease in Western countries, while in China, it is still in initial stage. Allison first attempted to control gastroesophageal reflux through surgical approach in 1951, but single hiatal hernia repair was inadequate to control reflux. Nissen developed fundoplication in 1955, and Rossetti modified it for reduction of the mobilized extent and related damage. The anti-reflux effect has been greatly improved but with high incidence of dysphagia and gas related complications. In order to solve these troublesome symptoms, Toupet and Dor came up with partial fundoplication, DeMeester and Donahue came up with "short floppy" Nissen fundoplication, they all successfully reduced the incidence of dysphagia and gas related complications but with preservation of anti-reflux effect.Thereafter, the three main stream fundoplication was formed (short floppy Nissen, Toupet and Dor procedures). In addition, other attempts for surgical control of gastroesophageal reflux were made, such as Belsey Mark Ⅳ, Hill and Collis procedures, but they are not as popular as fundoplication for a variety of reasons. In the meantime, the operative approach was converted from traditional laparotomy and thoracotomy to laparoscopic or robot-assisted laparoscopic era, and the anti-reflux effect was preserved with reduction in the duration of hospital stay and incidence of complications. Although plenty of anti-reflux procedures exists, they all with their own advantages and disadvantages, the concern for inadequate long-term anti-reflux effect and post-operative complications remains the main obstacle to the widespread of anti-reflux surgery. Better and more minimally invasive anti-reflux treatments should be explored.

More
广告
作者 吴继敏 [1] 陈冬 [1] 学术成果认领
作者单位 火箭军特色医学中心胃食管外科,北京 100088 [1]
栏目名称 专家论坛
DOI 10.3760/cma.j.cn112139-20200229-00162
发布时间 2025-02-25
  • 浏览274
  • 下载422
中华外科杂志

中华外科杂志

2020年58卷9期

677-682页

MEDLINEISTICPKUCSCDCA

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷