Sampson L K, Georgeson K E, Winters D C
Department of Surgery, The Children's Hospital of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Birmingham, Alabama 35233, USA.
Surg Endosc. 1996 Nov;10(11):1106-10. doi: 10.1007/s004649900253.
Infants and children requiring fundoplication for gastroesophageal reflux frequently have significant associated medical problems necessitating placement of a gastrostomy at the time of fundoplication. This article reviews the techniques, complications, and results of 141 laparoscopic Stamm gastrostomies performed in conjunction with laparoscopic fundoplication in infants and children. The three techniques employed were the T-fastener technique (63/141) which is best utilized in patients with thick abdominal walls; the trocar-site technique (53/141) which is technically easy to perform but prone to infection and fistula formation; and the U-stitch technique (26/141). General complications of laparoscopic gastrostomy include development of gastrocutaneous fistulae (2/141), perigastrostomy cellulitis (8/141), and the formation of granulation tissue at the gastrostomy site (45/141). The only perioperative death was due to a technical error during gastrostomy tube placement. Our preferred method for laparoscopic gastrostomy in most children is the U-stitch technique.
因胃食管反流而需要进行胃底折叠术的婴幼儿常常伴有严重的相关医学问题，这使得在进行胃底折叠术时需要同时放置胃造口术。本文回顾了141例在婴幼儿中与腹腔镜胃底折叠术联合进行的腹腔镜 Stamm 胃造口术的技术、并发症及结果。所采用的三种技术分别是：T型钉技术（63/141），最适用于腹壁较厚的患者；套管针穿刺部位技术（53/141），该技术操作简单，但容易发生感染和形成瘘管；以及U型缝合法（26/141）。腹腔镜胃造口术的一般并发症包括胃皮肤瘘的形成（2/141）、胃造口周围蜂窝织炎（8/141）以及胃造口部位肉芽组织的形成（45/141）。唯一的围手术期死亡是由于胃造口管放置过程中的技术失误。我们在大多数儿童中进行腹腔镜胃造口术的首选方法是U型缝合法。
