小儿食管贲门失弛缓症的腹腔镜Heller-Dor手术结果。
Results of the laparoscopic Heller-Dor procedure for pediatric esophageal achalasia.
作者信息
Mattioli G, Esposito C, Pini Prato A, Doldo P, Castagnetti M, Barabino A, Gandullia P, Staiano A M, Settimi A, Cucchiara S, Montobbio G, Jasonni V
机构信息
Pediatric Surgery, Gaslini Research Institute, University of Genova, Largo G. Gaslini, 5, 16100 Genova, Italy.
出版信息
Surg Endosc. 2003 Oct;17(10):1650-2. doi: 10.1007/s00464-002-9257-0. Epub 2003 Aug 15.
BACKGROUND
Esophageal achalasia is not a frequent disorder in children and different treatments have been proposed during past decades. This study reviews the results of the laparoscopic Heller-Dor procedure performed in pediatric patients in two different surgical units.
METHODS
We included the patients aged <14 years with a minimum follow-up of 6 months operated on in the period 1994-2001. A single longitudinal anterior esophageal myotomy (Heller) and a 180 degrees anterior gastropexy (Dor) were laparoscopically performed. The patients were checked to detect intra- or postoperative complications and recurrence.
RESULTS
Twenty children were operated on. Mean follow-up was 45 months (range 6-102). Postoperative clinical score was Visick 1 in 15 cases and Visick 2 in five.
CONCLUSIONS
As complication and recurrence rates are very low we consider modified Heller myotomy and Dor gastropexy through a laparoscopic approach our first choice to treat esophageal achalasia in the pediatric population.
背景
食管贲门失弛缓症在儿童中并不常见，在过去几十年中提出了不同的治疗方法。本研究回顾了在两个不同手术科室对儿科患者进行腹腔镜Heller-Dor手术的结果。
方法
我们纳入了1994年至2001年期间接受手术的年龄小于14岁且至少随访6个月的患者。通过腹腔镜进行单次纵向食管前肌切开术（Heller）和180度胃前固定术（Dor）。检查患者以发现术中或术后并发症及复发情况。
结果
20名儿童接受了手术。平均随访45个月（范围6 - 102个月）。术后临床评分Visick 1级15例，Visick 2级5例。
结论
由于并发症和复发率非常低，我们认为通过腹腔镜方法进行改良Heller肌切开术和Dor胃固定术是治疗儿科患者食管贲门失弛缓症的首选方法。
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