Long-term outcome of laparoscopic Nissen and Toupet fundoplication in normal and neurologically impaired children |
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Authors: | H Steyaert M Mohaidly MA Lembo L Carfagna S Tursini JS Valla |
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Institution: | (1) Department of Pediatric Surgery, Fondation Lenval pour Enfants, 57, Avenue de la Californie, F 06200, Nice, France, FR |
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Abstract: | Background: Laparoscopic fundoplication is a commonly performed procedure in children. This report describes the incidence
of long-term recurrence and complications after laparoscopic Nissen or Toupet fundoplication in neurologically impaired and
normal children. Methods: Fifty-three children operated on before 1999 were reviewed. All children were evaluated clinically
and with a barium meal study thereafter. Symptomatic children and those with abnormal barium meal underwent 24 h pH monitoring.
Results: A total of 45 patients were included in the study. The mean follow-up was 4.5 years. All, except one asymptomatic
child that declined, had a barium meal. Four were abnormal (2 parahiatal hernias and 2 slight episodes of reflux). Four patients
had symptoms related to the operation and 2 to clinical recurrence. Only 1 asymptomatic child with slight reflux at barium
meal revealed abnormal 24 h pH monitoring. Finally, 6.6% patients were found to have late recurrence (2 clinical and 1 pHmetry).
There was an obvious increase in children's weight, especially in neurologically impaired patients. Conclusion: Laparoscopic
antireflux surgery is of value in children with gastroesophageal reflux disease. The long-term results are comparable with
open surgery, and there was no difference in term of wrap failure between neurologically impaired and normal children. |
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