Laparoscopic Operation for Treatment of Cardiac Achalasia: Report of 5 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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刘源 ¹ , 杨福全 ¹ , 刘冰阳 ² , 王勇 ¹ , 刘金钢 ¹

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腹腔镜; 贲门失弛缓症

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目的探讨腹腔镜微创手术治疗贲门失弛缓症的应用价值。方法2007年11月至2009年12月期间，中国医科大学附属盛京医院微创外科对5例贲门失弛缓症患者实施腹腔镜改良Heller手术并胃底折叠术。结果手术过程顺利，手术时间120～165 min，平均139 min；术中失血50～200 ml，平均88 ml；术后第1天进食，吞咽困难症状消失，无手术相关并发症。 5例患者均痊愈出院。术后随访8～31个月，平均19个月，无症状复发或出现返流症状。结论腹腔镜手术治疗贲门失弛缓症安全、效果良好，值得进一步推广。

Citation： 刘源,杨福全,刘冰阳,王勇,刘金钢. Laparoscopic Operation for Treatment of Cardiac Achalasia: Report of 5 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(6): 659-661. doi: Copy

1.	Rosati F, Fumagalli U, Bonavina L, et al. Laparoscopic approach to esophageal achalasia [J]. Am J Surg, 1995, 169(4): 424427.
2.	蒋斌, 修典荣, 陆少美, 等. 腹腔镜下括约肌切开胃底折叠术治疗贲门失弛缓症 [J]. 中国微创外科杂志, 2003, 3(6): 515516.
3.	李业华, 张思宇. 经腹腔镜改良Heller手术加胃底折叠术治疗贲门失弛缓症 [J]. 腹腔镜外科杂志, 2005, 10(6): 323325.
4.	王相增, 佟赞, 李延茂, 等. 腹腔镜Heller肌切开联合胃底折叠术在贲门失弛缓症治疗中的应用 [J]. 腹腔镜外科杂志, 2009, 14(9): 660662.
5.	Heniford BT, Matthews BD, Kercher KW, et al. Laparoscopic anterior esophageal myotomy and toupet fundoplication for achalasia [J]. Am Surg, 2001, 67(11): 10591067.
6.	赵宏志, 秦鸣放, 王庆, 等. 腹腔镜联合胃镜微创治疗贲门失弛缓症26例分析 [J]. 中国实用外科杂志, 2010, 30(8): 684686.
7.	邹兵兵, 汪宏, 朱丹木, 等. 腹腔镜改良Heller手术治疗贲门失弛缓症 [J]. 腹腔镜外科杂志, 2008, 13(5): 396397.
8.	王秋生, 刘隆, 冀涛, 等. 腹腔镜手术治疗胃食管反流病和贲门失弛缓症 [J]. 外科理论与实践, 2004, 9(6): 458460.
9.	Campos GM, Vittinghoff E, Rabl C, et al. Endoscopic and surgical treatments for achalasia [J]. Ann Surg, 2009, 249(1): 4557.
10.	Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia [J]. Ann Surg, 2008, 248(6): 986993.
11.	Rebecchi F, Giaccone C, Farinella E, et al. Randomized controlled trial of laparoscopic hellermyotomy plus Dor fundoplication versus Nissen fundoplication for achalasia: longterm results [J]. Ann Surg, 2008, 248(6): 10231030.
12.	Wright AS, Williams CW, Pellegrini CA, et al. Longterm outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia [J]. Surg Endosc, 2007, 21(5): 713718.
13.	Oelschlager BK, Chang L, Pellegrini CA. Improved outcome after extended gastric myotomy for achalasia [J]. Arch Surg, 2003, 138(5): 490497.
14.	Kilic A, Schuchert MJ, Pennathur A, et al. Longterm outcomes of laparoscopic Heller myotomy for achalasia [J]. Surgery, 2009, 164(4): 826833.
15.	Schuchert MJ, Luketich JD, Landreneau RJ, et al. Minimallyinvasive esophagomyotomy in 200 consecutive patients: factors influencing postoperative outcomes [J]. Ann Thorac Surg， 2008, 85(5): 17291734.

1. Rosati F, Fumagalli U, Bonavina L, et al. Laparoscopic approach to esophageal achalasia [J]. Am J Surg, 1995, 169(4): 424427.
2. 蒋斌, 修典荣, 陆少美, 等. 腹腔镜下括约肌切开胃底折叠术治疗贲门失弛缓症 [J]. 中国微创外科杂志, 2003, 3(6): 515516.
3. 李业华, 张思宇. 经腹腔镜改良Heller手术加胃底折叠术治疗贲门失弛缓症 [J]. 腹腔镜外科杂志, 2005, 10(6): 323325.
4. 王相增, 佟赞, 李延茂, 等. 腹腔镜Heller肌切开联合胃底折叠术在贲门失弛缓症治疗中的应用 [J]. 腹腔镜外科杂志, 2009, 14(9): 660662.
5. Heniford BT, Matthews BD, Kercher KW, et al. Laparoscopic anterior esophageal myotomy and toupet fundoplication for achalasia [J]. Am Surg, 2001, 67(11): 10591067.
6. 赵宏志, 秦鸣放, 王庆, 等. 腹腔镜联合胃镜微创治疗贲门失弛缓症26例分析 [J]. 中国实用外科杂志, 2010, 30(8): 684686.
7. 邹兵兵, 汪宏, 朱丹木, 等. 腹腔镜改良Heller手术治疗贲门失弛缓症 [J]. 腹腔镜外科杂志, 2008, 13(5): 396397.
8. 王秋生, 刘隆, 冀涛, 等. 腹腔镜手术治疗胃食管反流病和贲门失弛缓症 [J]. 外科理论与实践, 2004, 9(6): 458460.
9. Campos GM, Vittinghoff E, Rabl C, et al. Endoscopic and surgical treatments for achalasia [J]. Ann Surg, 2009, 249(1): 4557.
10. Zaninotto G, Costantini M, Rizzetto C, et al. Four hundred laparoscopic myotomies for esophageal achalasia [J]. Ann Surg, 2008, 248(6): 986993.
11. Rebecchi F, Giaccone C, Farinella E, et al. Randomized controlled trial of laparoscopic hellermyotomy plus Dor fundoplication versus Nissen fundoplication for achalasia: longterm results [J]. Ann Surg, 2008, 248(6): 10231030.
12. Wright AS, Williams CW, Pellegrini CA, et al. Longterm outcomes confirm the superior efficacy of extended Heller myotomy with Toupet fundoplication for achalasia [J]. Surg Endosc, 2007, 21(5): 713718.
13. Oelschlager BK, Chang L, Pellegrini CA. Improved outcome after extended gastric myotomy for achalasia [J]. Arch Surg, 2003, 138(5): 490497.
14. Kilic A, Schuchert MJ, Pennathur A, et al. Longterm outcomes of laparoscopic Heller myotomy for achalasia [J]. Surgery, 2009, 164(4): 826833.
15. Schuchert MJ, Luketich JD, Landreneau RJ, et al. Minimallyinvasive esophagomyotomy in 200 consecutive patients: factors influencing postoperative outcomes [J]. Ann Thorac Surg， 2008, 85(5): 17291734.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic Operation for Treatment of Cardiac Achalasia: Report of 5 Cases

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