Veit F, Schwagten K, Auldist A W, Beasley S W
Department of Surgery, Royal Children's Hospital, Parkville, Victoria, Australia.
J Paediatr Child Health. 1995 Apr;31(2):121-6. doi: 10.1111/j.1440-1754.1995.tb00759.x.
To document changing trends in the indications for fundoplication in children with gastro-oesophageal reflux and to identify the main shortcomings and complications of the procedure.
Retrospective review of 405 consecutive children undergoing fundoplication between 1978 and 1992 inclusive.
Trends in the indications for fundoplication related to broadening of its use in those with severe neurological impairment and uncontrolled reflux, and to changes in the management of patients in the neonatal period. Complications included unwrapping with recurrence of reflux, hiatal hernia, adhesive small bowel obstruction, dumping syndrome, post-operative persistence of oesophageal stricture, excessively tight wrap and poor oesophageal clearance (mostly in oesophageal atresia patients).
This study identified those patients most likely to develop complications following fundoplication. This may assist in the pre-operative assessment of the likely benefit of fundoplication in children who often have other complex problems.
记录胃食管反流患儿行胃底折叠术适应证的变化趋势，并确定该手术的主要缺点和并发症。
回顾性分析1978年至1992年（含）期间连续接受胃底折叠术的405例患儿。
胃底折叠术适应证的趋势与该手术在严重神经功能障碍且反流未得到控制的患儿中使用范围的扩大，以及新生儿期患者管理的变化有关。并发症包括反流复发伴胃底折叠术松解、食管裂孔疝、粘连性小肠梗阻、倾倒综合征、术后食管狭窄持续存在、胃底折叠过紧及食管清除功能差（主要见于食管闭锁患者）。
本研究确定了胃底折叠术后最有可能发生并发症的患者。这可能有助于对常伴有其他复杂问题的儿童行胃底折叠术可能带来的益处进行术前评估。
