PubMed · 12496637
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A Bayat. 2003. A novel, triple-function vessel dilator.. https://doi.org/10.1097/00006534-200301000-00105
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Gastro-oesophageal reflux (GOR) is a major cause of morbidity in children who undergo surgical repair for oesophageal atresia with tracheo-oesophageal fistula (OA/TOF). We performed a retrospective analysis to determine the incidence of GOR on radionuclide scintigraphy in symptomatic and asymptomatic OA/TOF patients in the first post-operative year. A total of 124 patients (74 males, 50 females), with a mean age of 3.5 months (range, 20 days to 12 months), were studied. Of these 124 patients, 67 were symptomatic and 57 were asymptomatic. On radionuclide scintigraphy, 73 patients (48 symptomatic and 25 asymptomatic) had reflux. Of the 48 symptomatic patients with scintigraphic studies positive for reflux, 79.2% (38) had proximal reflux and 20.8% (10) had distal reflux, whereas, of the 57 asymptomatic patients, 48% (12) had proximal reflux and 52% (13) had distal reflux. There was a significantly higher incidence of GOR in symptomatic children than in asymptomatic children (P<0.01). In particular, there was a significantly higher incidence of proximal GOR in symptomatic children than in asymptomatic children (P<0.001). In conclusion, the severity and incidence of GOR were significantly higher in symptomatic than asymptomatic OA/TOF patients in their first post-operative year. Scintigraphic evidence of proximal reflux correlates with the presence of symptomatic GOR.
The most frequently occurring complications associated with the LAP-BAND (INAMED Health, Santa Barbara, CA) include gastric prolapse, stoma obstruction, esophageal and gastric pouch dilatation, erosion, and access port problems. This article describes the causes of these complications and details some points for their prevention and treatment. As techniques for placement of the LAP-BAND have evolved, complication rates have declined. For example, occurrence of gastric prolapse was reduced from the initially reported rates of 22% to less than 5%. The emergence of many problems, such as gastric pouch dilatation or prolapse, can be minimized with proper operative technique and close postoperative management and follow-up. As with other major surgical procedures, particularly those performed in the bariatric population, complications associated with the LAP-BAND system are unavoidable but are rarely life-threatening if managed appropriately. Surgeons and patients should adopt strategies that will help avoid complications and be sensitive to any indication of their emergence.