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小儿患者胃底折叠术临床结局的单中心经验:一项回顾性队列研究。

A single center experience on clinical outcome of fundoplication in pediatric patients: a retrospective cohort study.

作者信息

Oh Yuyoung, Youn Joong Kee, Yang Hee-Beom, Kim Hyun-Young, Ko Dayoung

机构信息

Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2025 Mar;108(3):177-185. doi: 10.4174/astr.2025.108.3.177. Epub 2025 Feb 28.

Abstract

PURPOSE

The study aimed to evaluate the characteristics and operative-related factors in children who underwent fundoplication, analyze surgical outcomes categorized by disease entity and surgical indication, and identify prognostic factors for reoperation risk.

METHODS

A total of 109 pediatric patients who underwent fundoplication between 2008 and 2022 were retrospectively analyzed. Patients were grouped by disease entity and surgical indication. Underlying diseases, comorbidities, sex, gestational age, birth weight, preoperative symptoms, and operation-related factors were examined. Outcomes were classified as short-term and long-term adverse events. We investigated differences in clinical outcomes according to disease entity and surgical indication. Then we statistically identified preoperative predictors for the risk of reoperation.

RESULTS

The most common disease entity was neurological impairment (n = 92). Pulmonary comorbidity (42.2%) and aspiration/regurgitation (87.2%) were the most common. Most surgeries were performed laparoscopically (86.2%). There were 12 short-term and 25 long-term adverse events, with long-term events occurred more frequently in the neurological impairment (NIP) group compared to the non-NIP group (P = 0.04). None of the factors showed a significant relationship with the risk of reoperation.

CONCLUSION

Neurologically impaired children were more likely to experience long-term adverse events post-fundoplication. However, no significant predictors for reoperation risk were identified.

摘要

目的

本研究旨在评估接受胃底折叠术的儿童的特征及手术相关因素,分析按疾病实体和手术指征分类的手术结果,并确定再次手术风险的预后因素。

方法

回顾性分析2008年至2022年间接受胃底折叠术的109例儿科患者。患者按疾病实体和手术指征分组。检查基础疾病、合并症、性别、胎龄、出生体重、术前症状及手术相关因素。结果分为短期和长期不良事件。我们根据疾病实体和手术指征调查临床结果的差异。然后我们通过统计学方法确定再次手术风险的术前预测因素。

结果

最常见的疾病实体是神经功能障碍(n = 92)。肺部合并症(42.2%)和误吸/反流(87.2%)最为常见。大多数手术通过腹腔镜进行(86.2%)。有12例短期不良事件和25例长期不良事件,神经功能障碍(NIP)组的长期不良事件发生率高于非NIP组(P = 0.04)。没有因素显示与再次手术风险有显著关系。

结论

神经功能障碍的儿童在胃底折叠术后更易发生长期不良事件。然而,未发现再次手术风险的显著预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e9b/11896763/d7d084af2d0b/astr-108-177-g001.jpg

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