Abstract:
BACKGROUND:Variation exists in the diagnostic testing for gastroesophageal reflux (GER) in infants and in the application of surgical therapy. There has been an increase in antireflux surgery (ARS) since the development of laparoscopy but the outcomes in high-risk infants is unclear. This study examines the results of laparoscopic fundoplication in infants less than 2 years. METHODS:The results of infants less than 2 years undergoing laparoscopic Nissen fundoplication (Lap-F) from 2012 to 2015 were retrospectively reviewed and outcomes were followed until 2017. RESULTS:There were 106 patients, median gestational age 32.50 weeks ± 6.35 SD and non-corrected age at operation 23.0 weeks ± 19.0 SD, mean weight of 4.81 kg ± 2.10 SD. One of the most common reasons for surgical consultation was improvement in respiratory status after insertion of nasoduodenal feeding tube. Of the Lap-F, 100 were with gastrostomy tube (GT). There were no conversions to open or intraoperative complications. The complication rate was 4.71%, and the reoperation rate was 5.66%, one fundoplication revision and the others gastrostomy revisions. The median time for feeds and to reach goal were 1 (1-14) and 4 (2-279) days, respectively. The 30-day mortality was 0.9% and long-term it was 4.71%. The long-term mortality was related to the underlying medical problems. The median follow-up was 113 (3-286) weeks. One patient required revision of the fundoplication and none required esophageal dilatation during the follow-up period. CONCLUSION:Fundoplication is effective for relief of symptoms of GER in children younger than 2 years. The procedure has a low morbidity and mortality in this population.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Rosales A,Whitehouse J,Laituri C,Herbello G,Long Jdoi
10.1007/s00383-018-4281-xsubject
Has Abstractpub_date
2018-07-01 00:00:00pages
749-754issue
7eissn
0179-0358issn
1437-9813pii
10.1007/s00383-018-4281-xjournal_volume
34pub_type
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journal_title:Pediatric surgery international
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journal_title:Pediatric surgery international
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journal_title:Pediatric surgery international
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journal_title:Pediatric surgery international
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journal_title:Pediatric surgery international
pub_type: 临床试验,杂志文章
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