Black T L, Fernandes E T, Ellis D G, Hollabaugh R S, Hixson S D, Mann C M, Miller J P, Wrenn E
Department of Pediatric Surgery, Cook-Fort Worth Children's Hospital, Fort Worth, TX 76104.
J Pediatr Surg. 1991 Feb;26(2):168-70. doi: 10.1016/0022-3468(91)90900-e.
Gastroesophageal reflux (GER) occurs frequently in infants with esophageal atresia (EA). The definitive management is primary repair and often includes tube gastrostomy. The recent finding of lower esophageal sphincter (LES) pressure changes with tube gastrostomy suggests that GER might be related to gastrostomy rather than EA per se. To evaluate this thesis, two populations of patients from different children's hospitals were reviewed: EA with and without routine gastrostomy. The two populations were similar with respect to number of infants, associated anomalies, distribution in the Waterston classification, morbidity, and mortality. One hundred sixteen patients were studied. Of the 66 survivors who underwent gastrostomy and repair of EA, 30 were found to have GER (45.5%) and 12 required fundoplication (18.2%). Of 31 surviving patients who underwent repair of EA without gastrostomy, 11 had GER (35.5%) and four required fundoplication (12.9%). These data suggest that tube gastrostomy does not significantly contribute to the GER associated with EA.
胃食管反流（GER）在食管闭锁（EA）患儿中频繁发生。确切的治疗方法是一期修复，通常包括胃造瘘术。近期研究发现，胃造瘘术会导致食管下括约肌（LES）压力改变，这表明GER可能与胃造瘘术有关，而非EA本身。为评估这一论点，回顾了来自不同儿童医院的两组患者：有和没有常规胃造瘘术的EA患者。这两组患者在婴儿数量、相关畸形、Waterston分类分布、发病率和死亡率方面相似。共研究了116例患者。在66例接受胃造瘘术和EA修复的幸存者中，30例有GER（45.5%），12例需要行胃底折叠术（18.2%）。在31例未行胃造瘘术而接受EA修复的存活患者中，11例有GER（35.5%），4例需要行胃底折叠术（12.9%）。这些数据表明，胃造瘘术对与EA相关的GER没有显著影响。
