| Objective:To discuss the curative effect of laparoscopic Nissen and Toupet fundoplication treatment on Gastroesophageal reflux disease. Methods:Review a total of 208 patients with Laparoscopic hiatal hernia repair and Nissen or Toupet fundoplication from September 2012 to September 2015. Laparoscopic Nissen fundoplication 156 case and Laparoscopic Toupet fundoplication 52 case. Compare the GERD-Q rating before and after the operation and Gastroscope, esophageal pressure and 24 h esophageal pH monitoring to evaluate the curative effect of two kinds of operation method.Results: Postoperative follow-up of 6 to 36 months, an average of 18.9months, two groups had no intraoperative and postoperative serious complications and deaths.Operation time, intraoperative blood loss, Nissen less than Toupet group, the more similar between the two groups have statistical significance(P＜0.05). Early postoperative dysphagia Toupet group less than Nissen, are similar between the two groups have statistical significance (P<0.05), Late postoperative dysphagia in the two groups is no statistical significance.GERD-Q rating compared the two groups before and after surgery itself had statistical significance; The contrast between the two way no statistical significance. Two kinds of operative methods esophageal pressure and acid measurement index contrast were significant difference compared before and after the surgery itself, but the comparison between the two groups has no statistical significance. Conclusion:Two kinds of laparoscopic fundoplication are safe and effective operation method. Laparoscopic Toupet relative laparoscopic Nissen surgery has a relatively low incidence of postoperatie dysphagia, but there was no difference in the long-term satisfaction of two groups of patients. Therefore, two kinds of operation how to choose should according to the actual circumstance of the patient and the surgeon technology and experience. |
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