在患有先前胃口术的儿童中进行 laparoscopic Nissen fundoplication:挑战和技巧
N Shan1, Y Alkhatib2, F Rossi3
1Nottingham university hospitals NHS Trust, Nottingham, UK. nisha.shan1@nhs.net.
Pediatric surgery international
|January 19, 2026
概括
使用现场胃口管 (G-管) 的腹腔镜基复合 (LF) 对胃食道逆流性疾病是安全的和可行的. 很少需要分离,但具有挑战性的情况下需要量身定制的端口放置以避免并发症.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 最少侵入性的手术
背景情况:
- 儿童的胃食道逆流性疾病 (GERD) 通常需要手术干预.
- 现场胃口管 (G-管) 在需要腹腔镜基复合 (LF) 的患者中很常见.
- 在LF期间切断G管的决定会影响操作复杂性和结果.
研究的目的:
- 评估腹腔镜内膜复合 (LF) 的可行性和结果,用于在位胃口管 (G-管) 的患者.
- 为了确定影响G管脱离在LF期间的需要的因素.
- 评估LF的安全性和有效性与保留的G管.
主要方法:
- 追溯分析了2014年至2024年期间由一名外科医生进行的170次LF手术.
- 将患者分为两组:有 (A组) 和没有 (B组) G管脱落的患者.
- 分析操作细节,包括操作时间和端口定位,以及术后结果.
主要成果:
- 在170个LF手术中,33个涉及患者在现场使用G管.
- 在85%的病例 (A组) 中避免了G管脱落,中位数的手术时间为75分钟.
- 五名患者 (15%,B组) 由于复杂的解剖学 (例如,巨型间隙,严重的脊椎病变) 需要G管分离,中位数的手术时间为100分钟.
- 在A组中没有出现早期的术后并发症,尽管五次基囊移植失败,需要重复LF.
- 在B组中,需要进行一次重复手术,因为在胃口切开后患有乳腺炎.
结论:
- 使用in-situ胃口管 (G-管) 的腹腔镜 fundoplication (LF) 是一种安全和可行的程序.
- G管的脱离很少需要,但与特定的具有挑战性的解剖学有关.
- 在复杂的情况下,量身定制的端口位置至关重要,以避免G管脱离及其相关风险.
相关概念视频
08:21Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
595
This study describes how 3D printed models effectively accelerate the rate at which advanced laparoscopic surgery skills used in Nissen Fundoplication are mastered by surgical residents during residency training, thereby enhancing future...
595
11:19Robotic Myotomy and Partial Fundoplication for Achalasia
1.9K
Surgical myotomy with a partial fundoplication may be used in selected patients as a definitive treatment for achalasia. This article provides a step-by-step description of a robotic myotomy and partial fundoplication in a 32-year-old patient with megaesophagus.
1.9K
14:15Measurement Of Neuromagnetic Brain Function In Pre-school Children With Custom Sized MEG
17.3K
The advent of MEG systems sized for young children opens important new opportunities to study brain development. The new system, together with a protocol that aligns experimental requirements with the capacities of children, can be used to study cognitive and language processes in healthy, awake children aged three to...
17.3K
08:57Laparoscopic Pancreatoduodenectomy With Modified Blumgart Pancreaticojejunostomy
15.9K
Laparoscopic pancreatoduodenctomy (LPD) may offer advantages over open pancreatoduodenectomy, including early postoperative mobilization, less delayed gastric emptying and a shorter hospital stay. However, LPD is technically challenging and not well-standardized, especially regarding the pancreatic anastomosis. We describe a standardized technique for the pancreatic anastomosis during LPD: modified Blumgart...
15.9K
10:52Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
5.8K
Presented here is a protocol of para-esophageal hernia repair. Use of absorbable biosynthetic mesh avoids the risk of erosion through the esophagus whilst reinforcing the repair. Glue fixation is preferred to avoid the risk of trauma such as bleeding or cardiac tamponade, which are associated with stitches or...
5.8K
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
871
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
871


