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
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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
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著者 | |
キーワード | gastro-esophageal reflux disease(GERD)
laparoscopic Nissen fundoplication
recurrence
esophagus direct suture
neurologically impaired(NI)children
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資料タイプ |
学術雑誌論文
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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
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ISSN | 00373699
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cat書誌ID | AN00102041
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出版者 | 徳島医学会
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巻 | 72
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号 | 3-4
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開始ページ | 101
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終了ページ | 106
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並び順 | 101
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発行日 | 2016-08-25
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EDB ID | |
フルテキストファイル | |
言語 |
jpn
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著者版フラグ |
出版社版
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部局 |
病院
医学系
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