Schatzlein M H, Ballantine T V, Thirunavukkarasu S, Fitzgerald J F, Grosfeld J L
Arch Surg. 1979 Apr;114(4):505-10. doi: 10.1001/archsurg.1979.01370280159026.
Eighty-three infants and children underwent surgical correction of gastroesophageal reflux (GER) from 1973 to 1978. Fifty-four patients had coexistent brain damage (most commonly due to cerebral palsy), eight were previously treated for esophageal atresia, and four had gastroschisis or omphalocele repair. Clinical presentation included failure to thrive in 64 patients, vomiting in 59, and recurrent bouts of aspiration pneumonitis in 43. Barium roentgenography showed GER in 61 patients, whereas additional tests (particularly pH monitoring) were required for detection of GER in 22 patients. After failure of medical management, transabdominal Nissen fundoplication was performed in 80 cases and a Hill repair in three cases. The surgical mortality was zero, but there were five late deaths. Results were considered excellent in 54 patients, good in 22 patients, and poor in seven. Ten of 12 patients with preoperative stricture responded to dilation after fundoplication. Nissen fundoplication was a safe and effective antireflux procedure in 76 of the 83 cases.
1973年至1978年期间，83名婴幼儿接受了胃食管反流（GER）的手术矫正。54例患者并存脑损伤（最常见的原因是脑瘫），8例曾接受食管闭锁治疗，4例曾行腹裂或脐膨出修补术。临床表现包括64例生长发育迟缓、59例呕吐以及43例反复发生的吸入性肺炎。钡剂X线造影显示61例患者存在GER，而另外22例患者需要进一步检查（尤其是pH监测）以检测GER。药物治疗无效后，80例行经腹Nissen胃底折叠术，3例行Hill修补术。手术死亡率为零，但有5例晚期死亡。54例患者结果为优，22例为良，7例为差。12例术前有狭窄的患者中，10例在胃底折叠术后对扩张治疗有反应。83例中的76例，Nissen胃底折叠术是一种安全有效的抗反流手术。
