关键词:  , 腹腔镜胃底折叠术； 胃食管返流性疾病； 高选择迷走神经切断术

Abstract:

Objective To compare the clinical effects of laparoscopic Nissen fundoplication(LNF)combined with highly selective vagotomy(HSV) (LNFHSV)in   treatment of gastroesophageal reflux disease(GERD),and to provide reference for the clinical application of LNFHSV.Methods 22 patients with a history of GERD unrelieved by medication and underwent LNFHSV were selected.At the same time ,36 patients with GERD underwent LNF were used as control.The  mean operation time,hospital stay,incidence of main operative complications,HSS complete remission and  Demeester scores of the patients in two groups were retrospectively analyzed.Results The Demeester scores,hospital stay,incidence of main operative complications of the patients in two groups before operation had no significant differences（P>0.05）.The mean operation time in LNFHSV group (90 min±35 min）was longer than that in LNF group（65 min±21 min）.The Demeester scores of the patients in two groups after operation had significant difference（P<0.05）.
The HSS complete remission rate of the patients in LNFHSV group was 91.1%,the part remission rate was 8.9%,and no effectiveness was  0;they were 83.3%，13.8%，and 2.8% in LNF group;there were significant differences between two groups（P<0.05）.Conclusion LNFHSV has better effectiveness in controlling GERD than LNF procedure.

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Key words: laparoscopic Nissen fundoplication, gastroesophageal reflux disease, peptic ulcer, highly selective vagotomy