Rothenberg Steven S
The Mother and Child Hospital at Presbyterian/St Luke's Medical Center, Denver, CO 80218, USA.
J Pediatr Surg. 2005 Jan;40(1):142-6; discussion 147. doi: 10.1016/j.jpedsurg.2004.09.031.
BACKGROUND/PURPOSE: Fundoplication for gastroesophageal reflux disease is a common procedure performed in infants and children. This report describes over a 10-year experience with more than 1000 consecutive laparoscopic Nissen fundoplications.
Ages ranged from 5 days to 18 years and weight from 1.2 to 120 kg. The procedures were performed using a 5 trocar technique and with 5- or 3-mm instruments depending on the size of the patient. Of 1050 fundoplications, 1048 were completed successfully through laparoscopy.
Average operative time dropped dramatically from 109 minutes for the first 30 cases compared with 38 minutes for the last 30. Intraoperative and postoperative complications were 0.26% and 4.0%, respectively. Average time to discharge post fundoplication was 1.1 days. The wrap failure rate is 4.0%.
This study shows in a large operative experience for 10 years that laparoscopic fundoplication is safe and effective in the pediatric population. Clinical results are comparable to the traditional open fundoplication but with a significant decrease in morbidity and hospitalization.
背景/目的：胃底折叠术用于治疗胃食管反流病，是婴幼儿和儿童中常见的手术。本报告描述了连续1000多例腹腔镜尼氏胃底折叠术超过10年的经验。
年龄范围为5天至18岁，体重为1.2至120千克。手术采用5套管针技术，根据患者大小使用5毫米或3毫米器械。在1050例胃底折叠术中，1048例通过腹腔镜成功完成。
前30例的平均手术时间为109分钟，而最后30例为38分钟，手术时间大幅下降。术中及术后并发症发生率分别为0.26%和4.0%。胃底折叠术后平均出院时间为1.1天。包裹失败率为4.0%。
这项为期10年的大型手术经验研究表明，腹腔镜胃底折叠术在儿科人群中安全有效。临床结果与传统开放胃底折叠术相当，但发病率和住院时间显著降低。
