Abstract：
BACKGROUND: Systemic inflammatory response is significant prognostic indicator in patients with various diseases. The relationship between prognostic scoring systems based on the modified Glasgow Prognostic Score (mGPS) and achalasia in patients treated with laparoscopic Heller‑myotomy with Dor‑fundoplication (LHD) remains uninvestigated. This study aimed to examine the role of mGPS in patients with achalasia.
METHODS: 457 patients with achalasia who underwent LHD as the primary surgery between September 2005 and December 2020 were included. We divided patients into the mGPS 0 and mGPS 1 or 2 groups and compared the patients\' background, pathophysiology, symptoms, surgical outcomes, and postoperative course.
RESULTS: mGPS was 0 in 379 patients and 1 or 2 in 78 patients. Preoperative vomiting and pneumonia were more common in patients with mGPS of 1 or 2. There were no differences in surgical outcomes. Postoperative upper gastrointestinal endoscopy revealed that severe esophagitis was more frequently observed in patients with mGPS of 1 or 2 (P < 0.01). The clinical success was 91% and 99% in the mGPS 0 and mGPS 1 or 2 groups, respectively (P < 0.01).
CONCLUSIONS: Although severe reflux esophagitis was more common in patients with achalasia with a high mGPS, good clinical success was obtained regardless of the preoperative mGPS.
METHODS: 457 patients with achalasia who underwent LHD as the primary surgery between September 2005 and December 2020 were included. We divided patients into the mGPS 0 and mGPS 1 or 2 groups and compared the patients\' background, pathophysiology, symptoms, surgical outcomes, and postoperative course.
RESULTS: mGPS was 0 in 379 patients and 1 or 2 in 78 patients. Preoperative vomiting and pneumonia were more common in patients with mGPS of 1 or 2. There were no differences in surgical outcomes. Postoperative upper gastrointestinal endoscopy revealed that severe esophagitis was more frequently observed in patients with mGPS of 1 or 2 (P < 0.01). The clinical success was 91% and 99% in the mGPS 0 and mGPS 1 or 2 groups, respectively (P < 0.01).
CONCLUSIONS: Although severe reflux esophagitis was more common in patients with achalasia with a high mGPS, good clinical success was obtained regardless of the preoperative mGPS.
摘要：
背景：全身炎症反应是各种疾病患者的重要预后指标。基于改良的格拉斯哥预后评分（mGPS）的预后评分系统与腹腔镜Heller-肌切开术伴Dor-胃底折叠术（LHD）治疗的患者的贲门失弛缓症之间的关系仍未得到研究。本研究旨在研究mGPS在贲门失弛缓症患者中的作用。
方法：纳入了2005年9月至2020年12月间以LHD为主要手术的457例门失弛缓症患者。我们将患者分为mGPS0组和mGPS1或2组，并比较患者的背景，病理生理学,症状,手术结果,和术后过程。
结果：mGPS在379例患者中为0，在78例患者中为1或2。术前呕吐和肺炎在mGPS为1或2的患者中更为常见。手术结果无差异。术后上消化道内镜显示，mGPS为1或2的患者更容易观察到严重食管炎（P<0.01）。在mGPS0和mGPS1或2组中，临床成功率分别为91％和99％，分别为(P<0.01)。
结论：尽管严重反流性食管炎在高mGPS的门失弛缓症患者中更为常见，无论术前的mGPS如何，均获得了良好的临床成功。
方法：纳入了2005年9月至2020年12月间以LHD为主要手术的457例门失弛缓症患者。我们将患者分为mGPS0组和mGPS1或2组，并比较患者的背景，病理生理学,症状,手术结果,和术后过程。
结果：mGPS在379例患者中为0，在78例患者中为1或2。术前呕吐和肺炎在mGPS为1或2的患者中更为常见。手术结果无差异。术后上消化道内镜显示，mGPS为1或2的患者更容易观察到严重食管炎（P<0.01）。在mGPS0和mGPS1或2组中，临床成功率分别为91％和99％，分别为(P<0.01)。
结论：尽管严重反流性食管炎在高mGPS的门失弛缓症患者中更为常见，无论术前的mGPS如何，均获得了良好的临床成功。
