2005 SAGES Abstracts

POSTER ABSTRACTS
silluminated the anterior abdominal wall, and secured the
stomach to the anterior abdominal wall with T-bar fasteners.
Using a modified Seldinger technique, we placed a gastrostomy
tube through the center of the T-bars.
Forty-seven children (mean age, 6.4 years), including 15
infants aged less that 1 year, underwent the procedure.
Indications for long-term enteral access included failure to
thrive (n=11), feeding disorder secondary to neurologic dysfunction
(n=31), gastroparesis (n=1), and dysphagia (n=4).
Forty procedures were performed in the operating room, three
in the neonatal intensive care unit and four in the pediatric
intesive care unit. Operative time averaged 23 minutes (range
12 to 45). One late complication occurred (gastrocolonic fistula).
The one minor complication was early dislodgement of the
gastrostomy tube, which required replacement. In this study,
the technique was found to be safe and effective for placing
gastrostomy tubes in infants and children.
P263–Esophageal/Gastric Surgery
DIVISION OF THE SHORT GASTRIC VESSELS DURING
LAPAROSCOPIC NISSEN FUNDOPLICATION, S Mehta MD, A
Hindmarsh MD,R Lowndes,M Rhodes MD, Department of
Upper Gastrointestinal Surgery, Norfolk and Norwich
University Hospital, Norwich, UK
Introduction
Division of the Short Gastric Vessels (SGV) during
Laparoscopic Nissen Fundoplication may be an important step
in reducing the prevalence of post-operative dysphagia.
Clinical outcome measures have been used in the past to
assess the relative importance of this technique. This study
prospectively evaluates both clinical outcome and physiological
measurements in patients with or without division of the
SGV.
Methods
204 patients underwent Laparoscopic Nissen Fundoplication
after 24 hr pH testing and manometry. Post-operatively they
were invited to have repeat physiology measurements at 4
months and symptom assessment at 6 months.
Results
110 patients had division of the SGV (Group 1), whilst 94 did
not (Group 2). Age and severity of reflux disease were similar
in the 2 groups. Mean DeMeester score improved from 38 to 8
in Group 1 and from 45 to 7 in Group 2(no significant difference
between groups). Mean lower oesophageal sphincter
pressure improved from 6.1 to 17.7 mmHg in Group 1 and
from 5.4 to 17.3 mmHg in Group 2 (no significant difference
between groups). Mean operating time was significantly
longer in those having division of the SGV (65 vs. 54 mins
p