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Giriş: Gastroözofageal reflü hastalığı (GÖRH), çocukluk yaş grubunda sık görülen hastalıklardan biridir. Özellikle nörolojik sorunları olan olgularda uygulanan fundoplikasyon işleminin akibeti hala tartışmalıdır. Son iki dekatta laparoskopik fundoplikasyon uygulamasının rutine girmesi ile cerrahi girişimlerde önemli ilerlemeler sağlanmıştır. Bu çalışmada biz açık ve laparoskopik Nissen fundoplikasyonu yaptığımız nörolojik problemi olan ve olmayanlarda postoperatif dönemdeki komplikasyonları karşılaştırmayı hedefledik. Materyal-Metod: Bu çalışmada kliniğimizde 2009-2014 yılları arasında gerçekleştirilen açık ve laparoskopik Nissen operasyonları ve sonrasında gelişen komplikasyonları retrospektif olarak incelenmiştir. Bulgular: Değerlendirmeye 5 gün - 18 yaş arası 29 kız ve 35 erkek hasta dahil edildi. Olguların 38'inde nörolojik problem mevcuttu. 14 olguya laparoskopik cerrahi, 50 olguya açık cerrahi tercih edildi. Postoperatif dönemde 31 hastada komplikasyon görülmezken 11 hastada yara enfeksiyonu, 9 hastada akciğer enfeksiyonu, 9 hastada kusma, 1 hastada hemopnömotoraks, 1 hastada mide perforasyonu gelişti. Postoperatif komplikasyona göre nörolojik problemleri olan ve olmayan hastalarımız arasında istatistiksel olarak anlamlı fark yoktu. Hiçbir hastada reflü nüksü veya hiatal herni gelişmedi. Çalışmamızda hastalarımız ortalama 20,43 +/- 13,34 gün arasında 4 gün ile 87 gün arasında hastanede kalmıştır. Laparoskopik ve açık Nissen operasyonu olan olgularda, hastane yatış süresi açısından bir fark yoktu. Sonuç: Sonuç olarak, laparoskopik ve açık fundoplikasyon olguları arasında hastaneye yatış ve komplikasyon oranları arasında fark yoktu. Ameliyat öncesi dönemde pnomoni varlığı, yapılacak cerrahi müdahalenin morbiditesini arttırmaktadır. Preoperatif akciğer problemlerini en aza indirdikten sonra operasyon planlanması bu hastalarda morbiditeyi azaltan en önemli faktördür.
Gastroosophageal reflus disease (GÖRH) is one of the common diseases in childhood age groups. The end of the fundoplikation process, especially in cases with neurological problems, should still be discussed. With the entry into routine of the laparoscopic fundoplikation application in the last two locations, significant advances have been made in the surgical trials. In this study, we aimed at comparing complications in the postoperative period in those with and non-neurological problems we have made clear and laparoscopic Nissen fundoplikation. Material-Method: In this study we retrospectively studied the open and laparoscopic Nissen operations performed in our clinic between 2009-2014 years and the subsequent developing complications. Results: 5 days - 29 girls and 35 male patients between the ages of 18 were included in the assessment. In 38 cases, there was a neurological problem. 14 cases were laparoscopic surgery, 50 cases open surgery were preferred. In the postoperative period there were no complications in 31 patients, whereas 11 patients had wound infection, 9 patients had lung infection, 9 patients had vomiting, 1 patient had hemopnomotoraks, 1 patient had stomach perforation. According to the postoperative complication, there was no statistically meaningful difference between our patients with and without neurological problems. No patient has developed reflux or hyatal hernia. In our study, our patients stayed in the hospital for an average of 20.43 +/- 13.34 days between 4 days and 87 days. In the facts of laparoscopic and open Nissen surgery, there was no difference in terms of the duration of hospitalization. Result: As a result, there was no difference between laparoscopic and open fundoplikation phenomena between hospitalization and complication rates. The presence of pneumonia in the pre-operative period increases the morbidity of the surgery to be performed. After preoperative lungs problems are reduced, the operation planning is an important factor in reducing morbidity in these patients.
Introduction: Gastroesophageal reflux (GERD) disease is one of the most common diseases in pediatric population. The fate of the fundoplication procedure, especially in patients with neurological problems, is still controversial. With the introduction of laparoscopic fundoplication application in the last two decades, significant advances have been made in surgical interventions. In this study, we aimed to compare the postoperative complications in patients with and without neurological problems with whom we performed open and laparoscopic Nissen fundoplication. Material-Metod: The aim of this study is to present laparoscopic and open Nissen fundoplication cases performed for GERD in our clinic between 2009-2014 and compare the complications. Results: 29 female and 35 male patients aged between 5 days -18 years (mean 7.06 +/- 5.16) were included in the evaluation. There were neurological problems in 38 of them were accompanied by neurological problems. laparoscopic surgery was performed to 14 cases and open surgery was preferred for 50 cases. In the postoperative period, while there were no complications in 31 patients, 11 cases had wound infection, 9 cases had pulmoner infection, 9 cases were vomiting, 1 case had hemopneumothorax, 1 case had a gastric perforation. Conclusion: The prevalence of pulmonary problems in the preoperative period, increases the morbidity of the surgical intervention to be made. The most important factor affecting morbidity in such patients, after minimizing preoperative pulmonary problems.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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