アクセス数 : ?
ダウンロード数 : ?
ID 110386
タイトルヨミ
イ ショクドウ ギャクリュウショウ ニ タイスル フククウキョウカ Nissen フンモン ケイセイジュツ ニオケル ショクドウ チョクセツ コテイ ノ ジュウヨウセイ ニ カンスル ケントウ
タイトル別表記
A study on the importance of the direct suture between the esophagus and diaphragmatic crus in laparoscopic Nissen fundoplication for gastro-esophageal reflux disease
著者
森, 大樹 徳島大学小児外科・小児内視鏡外科 徳島大学 教育研究者総覧 KAKEN研究者をさがす
石橋, 広樹 徳島大学小児外科・小児内視鏡外科 徳島大学 教育研究者総覧 KAKEN研究者をさがす
矢田, 圭吾 徳島大学小児外科・小児内視鏡外科 KAKEN研究者をさがす
キーワード
gastro-esophageal reflux disease(GERD)
laparoscopic Nissen fundoplication
recurrence
esophagus direct suture
neurologically impaired(NI)children
資料タイプ
学術雑誌論文
抄録
【Background】 For the neurologically impaired(NI)patients with gastro-esophageal reflux disease(GERD) who underwent laparoscopic Nissen fundoplication, the direct suture between the esophagus and diaphragmatic crus(esophagus direct suture)was changed from one to three stiches in order to prevent the postoperative recurrence due to wrap herniation. Therefore, the postoperative outcome was evaluated before and after this change retrospectively.
【Methods】 Seventy-two NI patients( 53 boys and 19 girls, mean age91. years old)with GERD performed laparoscopic Nissen fundoplication from 2005 to 2012 were enrolled in this study. Surgical procedure was laparoscopic Nissen fundoplication for all patients and additional gastrostomy at the same time for68cases(94%). Patients were divided into the following two groups : early period group(n=27)and late period group(n=45). The early period group included the number of esophagus direct suture was one stitch from2005to2007and the late period group included the number of esophagus direct suture was three stitches from2008to2012.
【Results】 There was no intraoperative complication in both two groups. In postoperative complication rate, there was no significant difference between the two groups though one case(2.2%)showed a gastric perforation in the late period group. Postoperative recurrence was found 9 cases (12.5%)due to wrap herniation. In postoperative recurrence rate, the early period group was 22.2%(n=6)and the late period group was 6.7%(n=3). The modified esophagus direct suture by from one stitch to three stitches had a tendency to decrease the postoperative recurrence rate(p=0.05). For nine recurrent cases, re‐operation was performed in two patients, esophagogastric dissociation in one patients and observation in six patients.
【Conclusions】 Devising the esophagus direct suture in the laparoscopic Nissen fundoplication for NI patients might have the possibility to prevent the recurrence due to wrap herniation.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
72
3-4
開始ページ
101
終了ページ
106
並び順
101
発行日
2016-08-25
EDB ID
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系