- 作者：Keith A. Thatch ; Edward Y. Yoo ; L. Grier Arthur III ; Christine Finck ; Douglas Katz ; Matthew Moront ; Rajeev Prasad ; Charles Vinocur ; Marshall Z. Schwartz
- 关键词：Neonatal laparoscopy ; Nissen fundoplication ; Gastrostomy ; Open fundoplication ; Laparoscopic fundoplication ; Neonatal antireflux surgery
- 刊名：Journal of Pediatric Surgery
- 出版年：2010
- 出版时间：February 2010
- 年：2010
- 卷：45
- 期：2
- 页码：346-349
- 全文大小：94 K
IntroductionThe aim of this study was to compare outcomes after laparoscopic and open techniques for Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit (NICU) population.Methods
The medical records for NICU inpatients who underwent laparoscopic and open Nissen fundoplication and gastrostomy placement from August 2002 to August 2008 were reviewed after Institutional Review Board approval. Each technique was compared with regard to operative time, estimated blood loss, postoperative 24-hour narcotic requirements, time to goal feeds, and complication rates. Analysis of variance was used to determine statistical significance. Data are quoted as mean ± SEM.
Results
Fifty-seven NICU patients underwent fundoplication and gastrostomy placement (25 laparoscopic and 32 open). The time to goal feeds was significantly shorter for the laparoscopic group (4.3 ± 0.4 vs 6.1 ± 0.6 days, P = .04). The 24-hour postoperative narcotic requirement was significantly lower in the laparoscopic group (0.24 ± 0.05 vs 0.55 ± 0.08 mg/kg, P = .007). Operation times (111 ± 5 [open] vs 113 ± 5 minutes, P = .76) and estimated blood loss (13 ± 2 [open] vs 11 ± 1 mL, P = .33) were comparable for both groups.
Conclusion
Laparoscopic and open techniques for Nissen fundoplication with gastrostomy placement are safe and appropriate treatment methods with equivalent operating times for the treatment of gastroesophageal reflux in the NICU population.