儿童沃森胃底折叠术：与尼森胃底折叠术的比较研究
Watson fundoplication in children: a comparative study with Nissen fundoplication.
作者信息
Wagener S, Sudhakaran N, Cusick E
机构信息
Bristol Royal Hospital for Children, UK.
出版信息
J Pediatr Surg. 2007 Jun;42(6):1098-102. doi: 10.1016/j.jpedsurg.2007.01.047.
BACKGROUND
Nissen fundoplication is the gold standard antireflux procedure in children. In 1996, one pediatric surgeon adopted the anterior fundoplication described by Watson in 1991. This procedure is reported to achieve good reflux control while permitting burping, active vomiting, and reducing gas bloat. An audit project was undertaken to compare the clinical outcome of children undergoing Nissen and Watson fundoplication.
METHODS
The case notes of 144 children undergoing open fundoplication between February 1995 and February 2002 were reviewed retrospectively.
RESULTS
Results of 72 boys and 59 girls comprising 76 Nissen and 55 Watson fundoplications were assessed. In each group, one death occurred within 1 month of operation. Chest infections occurred in 6.6% (Nissen) and 1.8% (Watson), and wound infections in 2.6% and 1.8%, respectively. Dysphagia was recorded in 7.9% of Nissen and 1.8% of Watson fundoplications. Follow-up data were analyzed in 70 children with Nissen and 48 children with Watson fundoplication. When overall clinical outcome was assessed for those patients with a minimum follow-up of 1 year, 85.1% Nissen and 88.2% Watson were judged good/excellent; 14.9% Nissen and 11.8% Watson were judged poor/bad.
CONCLUSION
Watson fundoplication can safely be performed in children with comparable clinical outcome to Nissen fundoplication.
背景
nissen胃底折叠术是儿童抗反流手术的金标准。1996年，一位儿科外科医生采用了1991年watson描述的前胃底折叠术。据报道，该手术在允许嗳气、主动呕吐并减少胃胀的同时，能有效控制反流。开展了一项审计项目，以比较接受nissen胃底折叠术和watson胃底折叠术的儿童的临床结果。
方法
回顾性分析了1995年2月至2002年2月期间144例行开放胃底折叠术的儿童的病历。
结果
评估了72名男孩和59名女孩的结果，其中包括76例nissen胃底折叠术和55例watson胃底折叠术。每组均有1例在术后1个月内死亡。胸部感染发生率分别为6.6%（nissen组）和1.8%（watson组），伤口感染发生率分别为2.6%和1.8%。nissen胃底折叠术患者吞咽困难发生率为7.9%，watson胃底折叠术患者为1.8%。对70例接受nissen胃底折叠术和48例接受watson胃底折叠术的儿童进行了随访数据分析。对那些至少随访1年的患者评估总体临床结果时，85.1%的nissen组和88.2%的watson组被判定为良好/优秀；14.9%的nissen组和11.8%的watson组被判定为差/不良。
结论
watson胃底折叠术可安全地应用于儿童，其临床结果与nissen胃底折叠术相当。
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