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비효율 식도운동(Ineffective Esophageal Motility)이 동반된 위식도역류 환자에서 복강경 항역류 수술(Laparoscopic Nissen Fundoplication)의 임상 결과에 관한 연구

  • 서재원 (대학원 의학과 내과학전공)

초록/요약

Ineffective Esophageal Motility Is Not Associated With Clinical Outcome After Laparoscopic Fundoplication. Background: Laparoscopic fundoplication is considered the ‘gold standard’ in antireflux surgery but some surgeons employ a different surgical strategy when gastro-esophageal reflux disease (GERD) is associated with motor disorders of the esophageal body. The aim of this study was to compare the results of laparoscopic nissen fundoplication for GERD in patients with normal esophageal motility and those with esophageal dysmotility. Methods: Forty-nine patients undergoing surgery for GERD were divided into two groups: 39 patients (group 1) had symptom improvement and 10 (group 2) had symptom non-improvement. All patients had a Nissen fundoplication via a laparoscopy. The median follow-up was 3 years in group 1 and 3.2 years in group 2. Results: The clinical outcome was satisfactory in 79.5 per cent of the patients. 19 of 39 patients with symptom improvement and 3 of 10 with symptom non-improvement had abnormal manometry finding ineffective esophageal motility (p = 0.122). DeMeester score was significantly increased in symptom improvement group (p = 0.025) Conclusion: Esophageal dysmotility such as IEM was not associated with clinical outcome after laparoscopic fundoplication. Laparoscopic fundoplication is an applicable procedure for GERD regardless of esophageal dysmotility.

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목차

CONTENTS

1. Introduction 1


2. Materials and methods 3


3. Results 5


4. Discussion 10


5. Conclusions 13


6. References 14


7. Abstracts 16

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