Hazebroek E J, Hazebroek F W J, Leibman S, Smith G S
Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia.
Dis Esophagus. 2008;21(8):742-5. doi: 10.1111/j.1442-2050.2008.00834.x. Epub 2008 May 2.
Patients with neuromuscular impairment, such as cerebral palsy or myotonic dystrophy, often suffer from oropharyngeal neuromuscular incoordination and severe gastresophageal reflux (GER). In 1997, Bianchi proposed total esophagogastric dissociation (TEGD) as an alternative to fundoplication and gastrostomy to eliminate totally the risk of recurrence of GER in neurologically impaired children. Little information exists about the best management for adult patients with severe neurological impairment in whom recurrent GER develops after failed fundoplication. We present our experience in three adult patients with neurological impairment in whom TEGD with Roux-en-Y esophagojejunostomy and feeding gastrostomy was performed for permanent treatment of GER.
患有神经肌肉损伤的患者，如脑瘫或强直性肌营养不良患者，常伴有口咽神经肌肉不协调和严重的胃食管反流（GER）。1997年，比安基提出全食管胃离断术（TEGD）作为胃底折叠术和胃造口术的替代方法，以完全消除神经功能受损儿童GER复发的风险。对于胃底折叠术失败后出现复发性GER的严重神经功能受损的成年患者，关于最佳治疗方法的信息很少。我们介绍了3例神经功能受损成年患者的经验，他们接受了TEGD联合Roux-en-Y食管空肠吻合术和喂养胃造口术，以永久性治疗GER。
