Esposito C, Garipoli V, De Pasquale M, Russo S, Palazzo G, Cucchiara S
Chair of Surgical Paediatrics, Federico II University of Naples, Italy.
Ital J Gastroenterol Hepatol. 1997 Oct;29(5):399-402.
BACKGROUND/AIMS: A retrospective study has been carried out on the last 20 consecutive patients operated for gastro-oesophageal reflux to compare the results of the traditional operation with those using the laparoscopic approach.
In ten cases, the operation was performed with an open traditional approach and in the other 10 cases using laparoscopy. The mean age of the patients was 7 years and their mean weight was 20 kg. There were 11 girls and 9 boys. We used a 360 degrees Nissen fundoplication in the patients operated on via laparotomy and a Nissen-Rossetti fundoplication in patients operated on via laparoscopy.
Mean operating time was 65 minutes for traditional surgery and 100 minutes for laparoscopy. There were two complications: 1 case of oesophageal perforation in a child affected by endo-brachyoesophagus with peri-oesophagitis, operated using the laparoscopic technique, and one case of wound infection in a child operated with the open technique. The hospital stay was remarkably shorter and less painful for the children operated on laparoscopically. At 13-month mean follow-up, all 20 patients are alive and present no reflux symptoms.
Our results demonstrate that laparoscopic surgery is a valid alternative to the traditional surgical approach for the treatment of gastro-oesophageal reflux.
背景/目的：对连续20例接受胃食管反流手术的患者进行了一项回顾性研究，以比较传统手术与腹腔镜手术的结果。
10例采用开放传统手术方式，另外10例采用腹腔镜手术。患者的平均年龄为7岁，平均体重为20千克。其中有11名女孩和9名男孩。我们对开腹手术的患者采用360度尼氏胃底折叠术，对腹腔镜手术的患者采用尼氏-罗塞蒂胃底折叠术。
传统手术的平均手术时间为65分钟，腹腔镜手术为100分钟。出现了2例并发症：1例采用腹腔镜技术手术的患有食管短缩症合并食管周围炎的儿童发生食管穿孔，1例采用开放技术手术的儿童出现伤口感染。腹腔镜手术患儿的住院时间明显更短，疼痛也更轻。平均随访13个月时，所有20例患者均存活，且无反流症状。
我们的结果表明，腹腔镜手术是治疗胃食管反流的传统手术方法的有效替代方案。
