Risks and benefits of surgical management of gastroesophageal reflux in neurologically impaired children.
Surg Endosc
; 17(5): 708-10, 2003 May.
Article
em En
| MEDLINE
| ID: mdl-12616396
ABSTRACT
BACKGROUND:
The aim of this study was to investigate the feasibility and results of laparoscopic antireflux procedure in neurologically impaired children.METHODS:
Over a 5-yr period, 259 children affected by gastroesophageal reflux disease underwent laparoscopic antireflux procedure. Eighty of them (30.8%) were neurologically impaired. In 58 children we performed an anterior fundoplication according to Thal and in 22 patients a 360 degrees fundoplication according to Nissen. Forty-eight children underwent an associated gastrostomy placement at the same time as the laparoscopic antireflux procedure.RESULTS:
We recorded 4/80 intraoperative complications; in all cases the complication was managed laparoscopically and no conversion was needed. Follow-up ranged from 6 months to 6 yrs (median 3 yrs). We recorded 24/80 postoperative complications, 5 of which required a redo procedure. We have a mortality rate of 17.5% but in only one case was the event related to the antireflux procedure.CONCLUSIONS:
Laparoscopic fundoplication can be performed safely and with acceptable results in neurologically impaired children. The indication to add a gastrostomy should be tailored to the needs of the individual patient. Mortality rate in neurologically impaired children patients with gastroesophageal reflux disease is high but in most cases unrelated to the antireflux procedure.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Refluxo Gastroesofágico
/
Doenças do Sistema Nervoso
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
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Infant
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Male
Idioma:
En
Revista:
Surg Endosc
Ano de publicação:
2003
Tipo de documento:
Article