Laparoscopic Nissen Fundoplication in Children with Neurological Impairment versus Neurologically Normal Children.
10.13029/jkaps.2016.22.2.49
- Author:
Yohan JOO
1
;
Ju Yeon LEE
;
Jung Hyun CHOI
;
Jung Man NAMGUNG
;
Seong Chul KIM
;
Dae Yeon KIM
Author Information
1. Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea. kimdy@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Gastroesophageal reflux;
Laparoscopy;
Fundoplication;
Neurologic deficit
- MeSH:
Body Weight;
Child*;
Colitis;
Deglutition Disorders;
Fundoplication*;
Gastric Emptying;
Gastroesophageal Reflux;
Humans;
Ileus;
Laparoscopy;
Neurologic Manifestations;
Outcome Assessment (Health Care);
Pneumonia;
Postoperative Complications;
Recurrence;
Reoperation;
Retrospective Studies;
Urinary Tract Infections;
Weight Gain;
Wound Infection
- From:Journal of the Korean Association of Pediatric Surgeons
2016;22(2):49-53
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study aimed to assess the long-term clinical outcome of laparoscopic Nissen fundoplication (LNF) in children according to their neurologic status. METHODS: The study retrospectively analyzed the data of 82 children (62 neurologically impaired and 20 neurologically normal children with primary gastroesophageal reflux disease) who had undergone LNF between 2003 and 2012. The main outcome measures were the occurrence of recurrence that required reoperation and post-procedure complications such as infections, pneumonia, and gastrointestinal complications including ileus, dysphagia, and delayed gastric emptying. RESULTS: The median age at the time of the LNF was 25 months (range, 1-192 months), and the median of body weight was 10.0 kg (range, 2.8-37.0 kg). The average weight gain was 1.55±1.68 kg at 6 months, 3.32±2.30 kg at 1 year, and 5.63±4.22 kg at 2 years after surgery. Six (9.7%) of the 62 neurologically impaired patients and two (10.0%) of neurologically normal lost their body weight or had no weight changes. Eight (12.9%) of the 62 neurologically impaired children had required redo surgery because of gastroesophageal reflux disease recurrences, while 2 (10.0%) of the 20 neurologically normal children had experienced recurrences. In the neurologically impaired children, the postoperative complications included pneumonia (n=1), wound infection (n=1), urinary tract infection (n=1), dysphagia (n=1), delayed gastric emptying (n=1), and ileus (n=2). All of these complications were not found in the neurologically normal group, except for only one case of infectious colitis. However, there was no statistically significant difference between the two groups in postoperative complications. CONCLUSION: The outcomes of laparoscopic fundoplication were similar in the neurologically impaired children and in the neurologically normal children.
