Laparoscopic Redo Nissen Fundoplication After Previous Open Antireflux Surgery in Infants and Children
Laparoscopic Redo Nissen Fundoplication After Previous Open Antireflux Surgery in Infants and Children
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DOI：
10.1089/lap.2013.0464
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发表时间：
2014-05-01
影响因子：
1.3
通讯作者：
Sydorak, Roman M.
中科院分区：
文献类型：
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作者：
Cheng, Amy W.;Shaul, Donald B.;Sydorak, Roman M.
复发性胃食管反流是胃底折叠术后常见的并发症。我们报告我们的经验，腹腔镜重做尼森胃底折叠术的儿科患者的历史开放抗反流程序。回顾所有有开放式抗反流手术史并随后接受腹腔镜再次Nissen胃底折叠术的患者的病历。2004年9月至2012年9月期间，共进行了180例腹腔镜Nissen胃底折叠术; 23例为重做手术。12例患者既往有开放性胃底折叠术史。平均手术间隔时间为113.7 +/- 64个月。7例患者出现呕吐，4例出现吸入性肺炎，1例出现临床返流。8例有脑瘫和/或癫痫发作病史。100%的患者完成了腹腔镜翻修，无术中并发症。平均手术时间为177.5 +/- 86分钟。7例患者能够在术后第1天恢复进食。平均住院时间为3天。中位随访时间为21个月。1例患者在8个月后因持续性吞咽困难需要再次抗反流手术。因此，在开放抗反流手术后进行腹腔镜Nissen胃底折叠术是可行和安全的。
Recurrent gastroesophageal reflux is a common complication after fundoplication procedures. We report our experience with laparoscopic redo Nissen fundoplications in pediatric patients with a history of open antireflux procedure. The medical records of all patients with a history of open antireflux procedure who underwent a subsequent laparoscopic redo Nissen fundoplication were reviewed. One hundred eighty laparoscopic Nissen fundoplications were performed between September 2004 and September 2012; 23 were redo procedures. Twelve patients had a history of prior open fundoplication. Average time between operations was 113.7 +/- 64 months. Seven patients presented with emesis, 4 with aspiration pneumonia, and 1 with clinical reflux. Eight had a history of cerebral palsy and/or seizure disorder. Laparoscopic revision was completed in 100% of the patients, with no intraoperative complications. Average operative time was 177.5 +/- 86 minutes. Seven patients were able to resume feeds on postoperative Day 1. Median length of stay was 3 days. Median follow-up was 21 months. One patient required a redo antireflux procedure 8 months later for persistent dysphagia. Thus laparoscopic revision Nissen fundoplication after a prior open antireflux procedure is feasible and safe.