Outcomes of fundoplication for paediatric gastroesophageal reflux disease

Purpose

Outcomes of fundoplication in children.

Methods

In this monocentric retrospective study, chart review was performed on children who underwent fundoplication between 2006 and 2013. Outcomes were defined as the need for redo fundoplication and recommencement of anti-reflux medication (ARM) at 6-month follow-up.

Results

119 patients underwent fundoplication with a mean age of 4.76 years and 55.5 % of these were male. At 6-month follow-up, 21 (17.6 %) required redo fundoplication and 64 (53.8 %) were recommenced on ARM. Post-operative complications occurred in 50 (42.2 %) of children; 30 % of those with complications had surgery at less than 1 year of age, and 36 % had an associated comorbid condition. Neither being under the age of one nor associated comorbidity was significantly associated with a poor outcome. Concurrent gastrostomy was associated with a higher risk of being back on ARM at 6-month follow-up (p = 0.003). Neither gastrointestinal or respiratory symptoms pre-surgery nor abnormal pre-operative investigations including pH monitoring and endoscopy were predictive of poor outcome post-fundoplication.

Conclusion

Although fundoplication has a role in the treatment of severe GORD in children, the majority of children in this study needed to restart their anti-reflux medications within 6 months of surgery.