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首页> 外文期刊>Surgical Endoscopy >Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children.
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Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children.

机译：腹腔镜Nissen-Rossetti胃底折叠术对神经功能障碍和正常儿童的长期结果。

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BACKGROUND: This study aimed to assess the long-term effects of laparoscopic Nissen-Rossetti fundoplication (LNF) on clinical and pH evaluations of children with gastroesophageal reflux disease (GERD) according to neurologic status. METHODS: The study examined 127 children (73 neurologically impaired and 54 neurologically normal with primary GERD) who consecutively underwent LNF from 1992 to 2003. The follow-up protocol included evaluations at 3, 15, and more than 36 months (long-term evaluation) postoperatively, which consisted of physical examination and 24-h pH monitoring. Recurrences were defined as abnormal pH-metry exhibited by symptomatic children. RESULTS: The long-term follow-up period averaged 5.5 years. Of the 73 neurologically impaired children, 9 (12%) had GERD recurrences, which occurred during the evaluation period and required redo surgery in four cases, including two Bianchi procedures. In the neurologically normal group, one recurrence (2%) occurred 3 months after surgery. The long-term complications in this group included dyspepsia (n = 3), occasional dysphagia (n = 2), gas bloat syndrome (n = 1), and alimentary disorders (n = 2). CONCLUSIONS: For children with primary GERD, LNF is a long-term efficient procedure. For the neurologically impaired children, the results were good, with more than 85% of the children symptom free after 5 years, although repeated evaluations are required to diagnose late recurrences related to evolving dysmotility disorders.
机译：摘要背景：本研究旨在评估腹腔镜尼森-罗塞蒂胃底折叠术（LNF）对根据神经系统状况对儿童胃食管反流病（GERD）的临床和pH值评估的长期影响。方法：该研究调查了1992年至2003年连续接受LNF的127例儿童（73例神经系统障碍和54例神经系统正常的原发性GERD）。随访方案包括在3、15和36个月以上的评估（长期评估） ）术后，包括体格检查和24小时pH监测。复发定义为有症状的儿童表现出的异常pH测量。结果：长期随访平均为5.5年。在73名神经系统受损的儿童中，有9名（12％）发生了GERD复发，该病在评估期间发生，需要进行重做手术的4例，包括两次Bianchi手术。在神经系统正常组中，术后3个月出现1例复发（2％）。该组的长期并发症包括消化不良（n = 3），偶发性吞咽困难（n = 2），气胀综合征（n = 1）和饮食失调（n = 2）。结论：对于原发性GERD患儿，LNF是一种长期有效的治疗方法。对于有神经系统障碍的儿童，结果是好的，5年后超过85％的儿童无症状，尽管需要反复评估以诊断与进化性运动障碍相关的晚期复发。

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