儿童腹腔镜Thal手术后的长期结果。

Seminars in laparoscopic surgery Pub Date : 2002-09-01
David C van der Zee, Klaas N M A Bax, B M Ure, M G H Besselink, D F M Pakvis
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引用次数: 0

摘要

随着腹腔镜下胃食管反流病(GERD)的方法在20世纪最后十年被引入儿科外科,这种方法显然是有益的。在21世纪初,良好的结果使这种手术得到了更广泛的接受和实施。我们对儿童腹腔镜反流手术的第一个十年进行了概述,重点介绍了腹腔镜下的索底术及其对正常儿童和智障儿童反流病的发病率和治疗的长期意义。在1993年至2002年间,149名患有胃食管反流的儿童接受了157次腹腔镜抗反流手术,其中48%患有智力障碍。随访6个月至9年(中位年龄4.5岁)。19名儿童死亡。除一例外,其余均与抗反流手术无关。120名儿童(80.5%)出现症状立即缓解。在29名儿童中,结果并不理想。8例患者接受了腹腔镜重做手术(5.4%)。然而,随访超过5年的儿童都没有出现任何症状。综上所述,腹腔镜下鼻窦扩底术是一种安全的手术,无论病因的性质如何,如智力低下,从长远来看效果都是良好的。
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Long-term results after laparoscopic Thal procedure in children.

As the laparoscopic approach to gastroesophageal reflux disease (GERD) was introduced in pediatric surgery in the last decade of the 20th century, it became apparent that this approach was beneficial. The favorable results have led to a more general acceptance and implementation of this type of surgery at the beginning of the 21st century. We give an overview of the first decade of laparoscopic antireflux procedures in children with an emphasis on the laparoscopic Thal fundoplication and its implication on morbidity and cure of GERD in the long term both for normal and mentally handicapped children. Between 1993 and 2002, 149 children with GERD underwent 157 laparoscopic antireflux procedures, of whom 48% were mentally handicapped. Follow-up ranged from 6 months to 9 years (median age 4.5 years). Nineteen children died. All but one were not related to the antireflux procedure. Immediate relief of symptoms occurred in 120 children (80.5%). In 29 children, the results were less than optimal. Eight patients underwent a laparoscopic redo procedure (5.4%). However, none of the children with a follow-up of more than 5 years show any symptoms anymore. In conclusion, the laparoscopic Thal fundoplication is a safe procedure, and results in the long term are favorable, irrespective of the nature of the cause, ie, mental retardation.

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