Filichia Lori A, Baz Maher A, Cendan Juan C
Department of Surgery, University of Florida, College of Medicine, Gainesville, Florida, USA.
JSLS. 2008 Jul-Sep;12(3):303-5.
Gastroparesis following lung transplantation can complicate medical management leading to malnutrition, weight loss, and erratic absorption of immunosuppressive medications, which are all important factors in the success of grafts. Gastric electrical stimulation has been shown to reduce the frequency of nausea and vomiting and lead to weight gain in patients with gastroparesis refractory to standard medical treatment; however, it has not yet been reported as being used for the treatment of gastroparesis in lung transplant recipients.
We report the case of a female bilateral lung transplant recipient suffering from severe gastric reflux and severe gastroparesis, who was successfully treated with simultaneous creation of a laparoscopic Nissen fundoplication and placement of a gastric stimulator.
The patient noted an immediate and sustained decrease in her symptoms of nausea and vomiting, and an increased appetite, and less variability in the serum levels of her immunosuppressive medication.
Lung transplant recipients with severe gastroparesis and reflux may benefit from Nissen fundoplication and gastric electrical stimulation.
肺移植后发生的胃轻瘫会使医疗管理变得复杂，导致营养不良、体重减轻以及免疫抑制药物吸收不稳定，而这些都是移植成功的重要因素。胃电刺激已被证明可减少难治性胃轻瘫患者的恶心和呕吐频率，并导致体重增加；然而，尚未有其用于治疗肺移植受者胃轻瘫的报道。
我们报告一例患有严重胃食管反流和严重胃轻瘫的双侧肺移植女性受者，她通过同时进行腹腔镜尼氏胃底折叠术和放置胃刺激器而获得成功治疗。
患者的恶心和呕吐症状立即且持续减轻，食欲增加，免疫抑制药物的血清水平波动减小。
患有严重胃轻瘫和反流的肺移植受者可能从尼氏胃底折叠术和胃电刺激中获益。
