腹腔镜Nissen's胃底折叠术治疗小儿胃食管反流性疾病

Laparoscopic Nissen's fundoplication in children with gastroesophageal reflux disease

目的 介绍腹腔镜Nissen’s胃底折叠术治疗小儿胃食管反流性疾病。方法 总结上海儿童医学中心 2001年 10月～2003年 2月、芝加哥大学儿童医院 2001年 7月～2002年 7月腹腔镜Nissen’s 胃底折叠术治疗小儿胃食管反流性疾病50例。患儿年龄1个月～17岁(平均年龄3.7岁)。结果 49例镜下完成Nissen’s术,平均手术时间93.8min(57～211 min)。术后平均1.3 d进食(1～4d),术后平均住院天数4.5 d(2～31 d),平均随访6.1个月(1～12个月),无胃食管反流复发。1例术中因开始经验和技术不足中转开腹。结论 腹腔镜Nissen’s胃底折叠术是治疗小儿胃食管反流性疾病有效的微创手术。具有术后疼痛轻、恢复快、并发症少等优点。

Objective To evaluate clinical outcome of laparoscopic Nissen' s fundoplication (LNF) in the treatment for gastroesophageal reflux disease(GERD) in children. Methods The charts of 50 chil- dren with GERD treated by LNF at Shanghai Children's Medical Center from October 2000 to February 2003 and The University of Chicago Children's Hospital from July 2001 to July 2002 were retrospectively reviewed. Their age ranged from 1 month to 17 years with an average of 3.7 years. Results All patients were successfully undergone LNF except one case converted to larparotomy because of deficiency in experi- ence in the early stage of LNF. The average operating time was 93.8 min (range, 57～211 min). The av- erage time of oral feeding was 1.3 days (range, 1～4 days) postoperatively. The mean hospitalization was 4.5 days after operation (range, 2～31 days). During the recent follow-up from 1～12 month (average 6.1 months), no recurrent reflux can be noted. Conclusion LNF is an effective and minimal invasive pro- cedure to treat GERD in children.