障害児胃食道逆流現象 (GER) : 自験例の検討

概要

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During an 11-year period, we surgically treated eight patients with gastroesophageal reflux who neurologically impaired. Their symptoms were hematemesis, anemia, stridor, frequent rerspiratory infection and poor weight gain. Apneic episodes occurred in four patients. Marked reflux of contrast medium into esophagus was in all patients. The interval from the onset of symptom to operation ranged from 5 years to 16 years. Nissen fundoplication, approximation of the esophageal hiatus and gastropexy were carried out in 6 patients, who showed no recurrence. Recurrence was noted in two patients, one who underwent only fundoplication, and the other, fundoplication and approximation of hiatus. Postoperative complication occurred in four patients : intestinal obstruction, prolonged gastric emptying, wound infection and intussusception of small intestine. Symptoms were alleviated in the patients without recurrence. These results suggest that surgery for GER in neurologically impaired patients requires close communication between the staff of the institute and families caring for the neurologically handicapped patients to ensure early treatment
日本小児外科学会の論文
1990-08-20