Laparoscopy in children: physiology and outcome

摘要: Background: Nowadays, in paediatric surgery, intra-abdominal procedures are commonly performed with a laparoscopic approach. Nevertheless, the effects and advantages of laparoscopy children have not been extensively investigated. Aims this thesis are: 1) To quantify absorption carbon dioxide (C02) during laparoscopy; 2) investigate if provides benefits compared to open surgery management common surgical conditions children. Methods: The includes two parts: one part focuses on C02 laparoscopy. second outcome Data were obtained by investigating procedures: Nissen fundoplication for treatment gastro-oesophageal reflux (GOR) Ramstedt pyloromyotomy pyloric stenosis. For fundoplication, follow-up study randomised controlled trial (RCT) including 38 was performed. Also, large review patients who underwent operation (redo-Nissen fundoplication) recurrent GOR pyloromyotomy, double blind, multicentre, international, RCT enrolling 180 Results: work demonstrates that 10-20% eliminated is derived from through peritoneum. results comparing shows antireflux procedure improves quality life controls independently technique used. associated an improvement gastric emptying post-operative period lower incidence retching at 4-year follow-up. In requiring redo-Nissen there high failure rate redo-fundoplication after primary has risk failure. reveals both successful. shorter recovery, analgesia requirement higher parental satisfaction.