摘要
食管下括约肌功能异常是胃食管反流病发病的重要病理学基础。磁性括约肌增强器固定在食管外的食管下括约肌功能区,静息状态下磁珠间吸引力可协助关闭食管下括约肌,起到抗反流作用。国外动物实验、临床试验结果均验证了磁性括约肌增强器治疗胃食管反流病的安全性、可行性、有效性。磁性括约肌增强器用于治疗难治性或合并巨大食管裂孔疝的胃食管反流病,也可以取得良好的临床疗效。与胃底折叠术对比研究结果显示两者临床疗效无差异,磁性括约肌增强器术后保留打嗝、呕吐等功能,且操作简便,不改变消化道生理结构。磁性括约肌增强器远期效果不断提升,并发症发生率逐渐降低,已在国内初步开展,有望成为胃食管反流病治疗的重要选择。
The lower esophageal sphincter incompetent is fundamental pathological abnormality of gastroesophageal reflux disease(GERD).Magnetic sphincter augmentation(MSA)is a magnetic bracelet,which designed to be placed surgically around the exterior surface of the distal esophagus.In the closed position,the highest attractive force between the magnetic beads would reinforce the lower esophageal sphincter to strengthen the antireflux barrier.Animal experiments and clinical trials have verified the safety and efficacy of MSA in GERD patients.For refractory GERD and GERD with huge hernia,MSA can also achieve acceptable clinical effect.Comparative researches appeared that there is no significantly difference in clinical effect between Nissen fundoplication and MSA.MSA could preserve the function of belching and vomiting postoperatively,and it can be implanted with the use of standard laparoscopic techniques.The long-term effect of MSA is satisfactory with less complications,which has been carried out in China since 2018.It can be predicted that MSA will play an important role in the treatment of GERD in the future.
作者
李志刚
Li Zhigang(Section of Esophageal Surgery,Department of Thoracic Surgery,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2020年第9期683-686,共4页
Chinese Journal of Surgery
关键词
胃食管反流
胸外科手术
磁性括约肌增强器
食管括约肌
下段
Gastroesophageal reflux
Thoracic surgical procedures
Magnetic sphincter augmentation
Esophageal sphincter,lower
