실패한 Nissen 술을 Belsey Mark IV 위바닥주름술로 교정한 1예
A Case of Belsey Mark IV Fundoplication after Failed Nissen Antireflux Surgery
손수민, 박문호, 김애석, 황진복, 신현정, 금동윤, 박창권, 최원정,
소속 상세정보
손수민 ( Shon Su-Min )
계명대학교 의과대학 소아과학교실
박문호 ( Park Moon-Ho )
계명대학교 의과대학 소아과학교실
김애석 ( Kim Ae-Suk )
동국대학교 의과대학 소아과학교실
황진복 ( Hwang Jin-Bok )
계명대학교 의과대학 소아과학교실
신현정 ( Shin Hyun-Jung )
계명대학교 의과대학 소아과학교실
금동윤 ( Keum Dong-Yoon )
계명대학교 의과대학 흉부외과학교실
박창권 ( Park Chang-Kwon )
계명대학교 의과대학 흉부외과학교실
최원정 ( Choi Won-Joung )
계명대학교 의과대학 효성아동병원 소아과
KMID : 0816120060090010103
Abstract
Antireflux surgery has been indicated in gastroesophageal reflux disease (GERD) that does not respond to medical treatments. Although the most commonly performed operation is Nissen fundoplication, Belsey Mark IV fundoplication is indicated for more complicated cases, such as, in cases of a failed Nissen operation or a long lasting hiatal hernia. Here, we report a case of Belsey Mark IV fundoplication for a failed Nissen fundoplication. The infant developed frequent times of aspiration pneumonia after initial Nissen for a hiatal hernia with GERD during the newborn period. At 15 months of age, a 2nd Nissen operation was attempted, but fundoplication was not available because of excessive mesenteric adherence to the liver and cardia. Therefore, Belsey Mark IV fundoplication was performed via trans-thoracic approach, which can provide full esophageal mobilization and better visualization of the herniated fundus and the surrounding tissues. Subsequently, she has shown an improved general condition without GERD.
키워드
Nissen fundoplication;Belsey Mark IV fundoplication;Hiatal hernia;Gastroesophageal reflux disease
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