Nissen fundoplication in children with and without neurological impairment: A prospective cohort study

J Pediatr Surg. 2016 Jul;51(7):1115-21. doi: 10.1016/j.jpedsurg.2015.12.007. Epub 2015 Dec 22.

Abstract

Background: It is assumed that children with neurological impairment (NI) have inferior results after fundoplication compared to those without NI (non-NI). The aim of this study was to assess outcome after fundoplication in children with and without NI.

Methods: 87/105 patients (46 NI, 41 non-NI) undergoing fundoplication between 2003 and 2009 were included in this prospective two-center cohort study. Complications occurring within the first 30days were scored from 0 to 100 by the comprehensive complication index (CCI). Follow-up included clinical examination, upper gastrointestinal contrast study and 24-h pH monitoring 6months postoperatively, then phone-interviews 1, 2 and 4years later.

Results: There were no statistical differences in age (NI 3.1 years [0.2-15.2] vs non-NI 5.0 years [0.4-15], p=.14) or in total CCI score (NI 20.9 [0-44.9] vs non-NI 8.7 [0-40.6], p=.57). Hospital stay was longer for NI children (9days [4-57] vs non-NI: 4days [2-16], p<0.001). More than 90% of parents in both groups reported that the fundoplication had improved the child's overall condition. Recurrence of gastroesophageal reflux disease (GERD) was diagnosed in 12 NI and 7 non-NI patients (p=.31).

Conclusions: Early complications, GERD recurrence, and long-term parental satisfaction after fundoplication did not differ between NI and non-NI patients.

Keywords: Antireflux surgery; Child; Fundoplication; GER; Gastroesophageal reflux; Gerd.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Fundoplication* / methods
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Laparoscopy*
  • Male
  • Nervous System Diseases / complications*
  • Prospective Studies
  • Treatment Outcome