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首页> 外文期刊>Surgical Endoscopy >Laparoscopic refundoplication in children.
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Laparoscopic refundoplication in children.

机译：小儿腹腔镜下的复叠术。

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BACKGROUND: Gastroesophageal fundoplication currently is one of the three most common major operations performed on infants and children by pediatric surgeons in the United States. With the advent of laparoscopic surgery, the number of gastroesophageal fundoplications has virtually exploded. Morbidity always was substantial with this operation, and laparoscopy has not changed this. We describe our results with laparoscopic refundoplication in infants and children. METHODS: From December 1993 to December 1998 100 children underwent a laparoscopic 180 degrees anterior wrap using the Thal procedure. Four children had to undergo a laparoscopic refundoplication. Two of these children were mentally handicapped. All of the children had recurrent symptoms, but only two of the four had an abnormal pH study. In three of the children, the Thal procedure was changed to a Nissen (n = 2) and Toupet (n = 1) fundoplication. One child with an intrathoracic wrap and a giant hiatal hernia underwent hernia repair with a Goretex patch and a redo-Thal. RESULTS: In two of the children, the operation was relatively simple. For one child, the procedure had to be converted for anesthesiologic reasons. The procedure in the fourth child was more difficult because of a large hiatal hernia. Within a follow-up time of 2 to 4 years, all the children were free of pathologic gastroesophageal reflux symptoms and afterward displayed no recurrence. CONCLUSION: In children, laparoscopic refundoplication after a previous laparoscopic antireflux Thal procedure is feasible and does not increase morbidity.
机译：背景：胃食管胃底折叠术目前是美国儿科医生对婴儿和儿童进行的三种最常见的主要手术之一。随着腹腔镜手术的出现，胃食管胃底折叠术的数量实际上激增了。该手术的发病率一直很高，腹腔镜检查并没有改变这一情况。我们用婴幼儿腹腔镜回肠复制描述我们的结果。方法：从1993年12月至1998年12月，采用Thal手术对100名儿童进行了180度腹腔镜前包裹。四个孩子不得不进行腹腔镜下的重复复制术。这些孩子中有两个是弱智的。所有的孩子都有复发的症状，但是四个孩子中只有两个有异常的pH研究。在三个孩子中，Thal手术改为Nissen（n = 2）和Toupet（n = 1）胃底折叠术。一名胸腔内包裹着巨大食管裂孔疝的儿童接受了Goretex贴片和Redo-Thal疝修补术。结果：在两个孩子中，手术相对简单。对于一个孩子，由于麻醉原因，必须改变程序。由于裂孔疝较大，第四个孩子的手术更加困难。在2至4年的随访时间内，所有患儿均未出现病理性胃食管反流症状，此后均未复发。结论：对于儿童，在先前的腹腔镜抗反流Thal手术后进行腹腔镜下复活是可行的，不会增加发病率。

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