Lintula Hannu, Antila Pentti, Kokki Hannu
Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland.
J Laparoendosc Adv Surg Tech A. 2003 Dec;13(6):381-5. doi: 10.1089/109264203322656450.
Children with a gastrostomy may require laparoscopic fundoplication (LF).
Children with a gastrostomy who underwent LF between 1998 and 2002 were reviewed. The outcomes of children undergoing LF were compared with a group of children without a gastrostomy who had the same operation during the same period.
Ten children with a gastrostomy in place and eight children without a gastrostomy underwent LF. The median operating time was 198 minutes (range, 115-300 minutes) in the gastrostomy group and 110 minutes (range, 80-130 minutes) in the non-gastrostomy group (P =.002). In the gastrostomy group, two children had ventriculoperitoneal shunts and two had extensive intra-abdominal adhesions due to peritonitis. One laparoscopic procedure in each group was converted to an open approach. A successful LF was performed in nine of the ten children without taking down the gastrostomy. One child with a gastrostomy experienced recurrent vomiting that was managed with a gastrojejunal tube. One child in the non-gastrostomy group required reoperation due to an esophageal stricture.
It seems that LF can be performed safely and effectively in children with a preexisting gastrostomy. LF in children with a gastrostomy seems to be as efficacious as LF in children without a gastrostomy.
有胃造口术的儿童可能需要腹腔镜胃底折叠术（LF）。
对1998年至2002年间接受LF的有胃造口术的儿童进行回顾。将接受LF的儿童的结果与同期接受相同手术的一组无胃造口术的儿童进行比较。
10名有胃造口术的儿童和8名无胃造口术的儿童接受了LF。胃造口术组的中位手术时间为198分钟（范围115 - 300分钟），非胃造口术组为110分钟（范围80 - 130分钟）（P = 0.002）。在胃造口术组中，两名儿童有脑室腹腔分流管，两名儿童因腹膜炎有广泛的腹腔内粘连。每组各有一例腹腔镜手术转为开放手术。10名有胃造口术的儿童中有9名在未拆除胃造口术的情况下成功进行了LF。一名有胃造口术的儿童出现反复呕吐，通过胃空肠管进行处理。非胃造口术组中有一名儿童因食管狭窄需要再次手术。
似乎在已有胃造口术的儿童中可以安全有效地进行LF。有胃造口术的儿童进行LF似乎与无胃造口术的儿童进行LF一样有效。
