Department of Pediatric Surgery, Erasmus MC-Sophia, Rotterdam, The Netherlands.
J Pediatr Surg. 2010 Feb;45(2):350-4; discussion 354. doi: 10.1016/j.jpedsurg.2009.10.077.
Delayed gastric emptying (DGE) as indicated by preoperative gastric emptying scan (GES) is one rationale for performing a gastric emptying procedure (GEP) at time of fundoplication for gastroesophageal reflux disease (GERD). However, the role of GES and GEP in the surgical management of GERD remains unclear. We examined the use of preoperative GES in fundoplication patients.
Retrospective chart review of patients undergoing fundoplication from 2000 to 2005 in a single institution including patient demographics, operative procedure, and postoperative outcomes at 1-year follow-up was analyzed using chi(2) test.
Of 76 fundoplication patients, 39 (51%) had preoperative GES with 11 patients (28%) having DGE and 16 GEP performed. Developmentally delayed children were more likely to have GES. There were no significant differences in postoperative complications, length of hospital stay, or use of anti-GERD medications at 1 year between patients who had preoperative GES and those who did not. In the developmentally delayed group, there were no differences in outcomes between those with preoperative GES and those who did not.
There were no differences in outcomes for GERD patients with or without preoperative GES or GEP postfundoplication. The use of GES in the management of GERD requires further evaluation.
术前胃排空扫描（GES）显示胃排空延迟（DGE）是胃食管反流病（GERD）患者在行胃底折叠术时行胃排空术（GEP）的一个理论依据。然而，GES 和 GEP 在 GERD 手术治疗中的作用仍不清楚。我们研究了术前 GES 在胃底折叠术患者中的应用。
回顾性分析 2000 年至 2005 年在一家机构行胃底折叠术的患者的病历，使用卡方检验分析患者的人口统计学、手术操作以及术后 1 年的随访结果。
76 例胃底折叠术患者中，39 例（51%）行术前 GES，其中 11 例（28%）存在 DGE，并进行了 16 例 GEP。发育迟缓的儿童更有可能进行 GES。术前进行 GES 的患者与未行 GES 的患者相比，在术后并发症、住院时间或使用抗 GERD 药物方面，在术后 1 年时无显著差异。在发育迟缓组中，术前 GES 与未行 GES 的患者在结局方面无差异。
GERD 患者行或不行术前 GES 或 GEP 后，胃底折叠术的结局无差异。在 GERD 的管理中使用 GES 需要进一步评估。
