Meehan J J, Georgeson K E
Division of Pediatric Surgery, Department of Surgery, The Children's Hospital of Alabama, 300 ACC, 1600 7th Avenue South, Birmingham, AL 35233, USA.
Surg Endosc. 1996 Dec;10(12):1154-7. doi: 10.1007/s004649900269.
Laparoscopic fundoplication is a new method for treating gastroesophageal reflux in children. We present 160 children with gastroesophageal reflux treated by laparoscopic fundoplication.
Patients underwent either a laparoscopic Nissen or Toupet fundoplication. Many patients also required gastrostomies and gastric outlet procedures.
Twelve patients (7.5%) were converted to open fundoplication. Laparoscopic gastrostomies were placed in 112 patients (75.7%) and laparoscopic gastric outlet procedures in 62 patients (41.9%). Feedings were initiated by postoperative day 2 in 126 children (85.7%). Sixty-four percent were discharged by postoperative day 3. Complications occurred in 11 of 148 fundoplications (7.4%), in nine of 112 gastrostomies (8.0%), and in three of 62 gastric outlet procedures (4.8%). One patient died as a result of a surgical error in placing a gastrostomy (0.7%).
Laparoscopic fundoplication appears to foster a more rapid recovery and decreased hospital stay while maintaining complication rates similar to or better than open fundoplication.
腹腔镜胃底折叠术是治疗儿童胃食管反流的一种新方法。我们报告了160例接受腹腔镜胃底折叠术治疗的胃食管反流患儿。
患者接受了腹腔镜nissen或Toupet胃底折叠术。许多患者还需要进行胃造口术和胃出口手术。
12例患者（7.5%）转为开腹胃底折叠术。112例患者（75.7%）进行了腹腔镜胃造口术，62例患者（41.9%）进行了腹腔镜胃出口手术。126名儿童（85.7%）在术后第2天开始进食。64%的患者在术后第3天出院。148例胃底折叠术中11例（7.4%）发生并发症，112例胃造口术中9例（8.0%）发生并发症，62例胃出口手术中3例（4.8%）发生并发症。1例患者因胃造口手术失误死亡（0.7%）。
腹腔镜胃底折叠术似乎能促进更快恢复并缩短住院时间，同时保持与开腹胃底折叠术相似或更低的并发症发生率。
