Complications and Long-Term Results of the Nissen Fundoplication

Hanimann, B; Sacher, Paul; Stauffer, U. G.

doi:10.1055/s-2008-1063499

Cited by 16 publications

(7 citation statements)

References 6 publications

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“…At follow-up with a mean period of 8.7 years following Nissen fundoplication, 87.5 % showed good results without any residual symptoms. These clinical results compare favorably with previously published data from various centers (13,18,29,32). However, the complication rate was as high as 50 %.…”

Section: Discussionsupporting

confidence: 89%

“…Nissen fundoplication is the most widely used procedure and has been reported to give good control of gastroesophageal reflux. Several reports, however, documented a significantly high complication rate following the Nissen fundoplication (9, 13,29). For this reason, over the last 20 years, several reports have been published advocating other antireflux procedures (4-6, 8).…”

Section: Mots-elesmentioning

confidence: 99%

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Nissen Fundoplication and Boix-Ochoa Antireflux Procedure: Comparison between Two Surgical Techniques in the Treatment of Gastroesophageal Reflux in Children

et al. 1999

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Over a period of 19 years an antireflux procedure was performed for gastroesophageal reflux in 59 children. Thirty-two patients underwent Nissen fundoplication and 27 children underwent the Boix-Ochoa antireflux procedure. Six patients died between two and 15 months post surgery of unrelated causes. Follow-up period from six months to 18 years was available in 45 (85%) of the surviving patients. This report summarizes the complications and long-term results with the two surgical procedures and their comparisons. The follow-up evaluation included parental interview and physical examination. Upper GI series and pH monitoring were performed only in children with signs and symptoms of recurrent GER or other post-operative complications. At follow-up with a mean period of 8.7 years following Nissen fundoplication, 87.5% showed good results without any residual symptoms. However, the overall complication rate was as high as 50%. Following the Boix-Ochoa antireflux procedure, 17 (81%) children showed excellent results while four children had recurrent GER. This occurred in two neurologically impaired children and two patients following esophageal atresia repair. No other post-operative complications were encountered with the Boix-Ochoa antireflux procedure. In our experience, the Boix-Ochoa antireflux procedure should be the procedure of choice in the surgical treatment of GER in otherwise normal children while the Nissen fundoplication is preferable in neurologically impaired children and in patients with GER following esophageal atresia repair.

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Section: Discussionsupporting

confidence: 89%

Section: Mots-elesmentioning

confidence: 99%

Nissen Fundoplication and Boix-Ochoa Antireflux Procedure: Comparison between Two Surgical Techniques in the Treatment of Gastroesophageal Reflux in Children

et al. 1999

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“…Delayed gastric emptying is a known predisposing factor for wrap failure [20,21]. Failed fundoplication can be a challenging problem and it is better avoided.…”

Section: Surgical Managementmentioning

confidence: 99%

Gastric emptying of solids in normal children—a preliminary report

Singh¹,

Gibbons²,

Blackshaw³

et al. 2006

Journal of Pediatric Surgery

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“…Although the initial treatment for Ger, especially in newborns is clinical 21 , surgical treatment may be indicated in cases where anatomical disorders are present or when clinical treatment is ineffective and associated with lifethreatening conditions 22,23 . In these instances, it has been demonstrated that the Nissen fundoplication can be accomplished safely with a low incidence of complications 24 .…”

Section: Discussionmentioning

confidence: 99%

Babies with brain damage who can not swallow: surgical management

Silva

Schmidt

Mezzacappa

et al. 2008

Arq. Neuro-Psiquiatr.

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-Background:Neonates with severe neurological impairment are often unable to swallow, necessitating gastrostomy for feeding. Because of the risk of developing severe reflux, this procedure is often associated with fundoplication. Objective: To assess the safety and efficacy of gastrostomy and Nissen fundoplication in 22 neonates with swallowing difficulties due to serious neurological impairment. Method: All children underwent an initial period of nasogastric feeding and after informed consent underwent gastrostomy and Nissen fundoplication. Results: There were no significant intraoperative complications. There were two cases of postoperative periostomy leakage. Of the 22 neonates 16 were alive four months after surgery. Six neonates died of complications due to underlying disease. Conclusion: We concluded that gastrostomy and Nissen fundoplication are safe procedures and help parents give a better care to these children.Key WOrdS: gastrostomy, newborn, brain damage, fundoplication, gastroesophageal reflux. recém-nascidos com lesão cerebral que não deglutem: manejo cirúrgicoResumo -Introdução: Neonatos com dano neurológico são freqüentemente incapazes de deglutir necessitando de gastrostomia para alimentação. devido ao risco de refluxo grave, esse procedimento é associado à fundoplicatura. Objetivo: Avaliar a segurança e eficácia da gastrostomia com fundoplicatura Nissen em 22 neonatos com dificuldades de deglutição devido à lesão neurológica grave. Método: Todos os neonatos foram submetidos a um período inicial de alimentação por sonda nasogástrica e, após consentimento informado, foram submetidos a gastrostomia com fundoplicatura Nissen. Resultados: Não houve complicações intraoperatórias significativas. Houve dois casos de vazamento pós-operatório da ostomia. dos 22 neonatos, 16 estavam vivos 4 meses após a cirurgia. Seis neonatos morreram por complicações devido à doença de base. Conclusão: A gastrostomia com fundoplicatura Nissen é procedimento seguro e ajuda os pais a darem melhor cuidado a crianças com lesão neurológica.

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Complications and Long-Term Results of the Nissen Fundoplication

Cited by 16 publications

References 6 publications

Nissen Fundoplication and Boix-Ochoa Antireflux Procedure: Comparison between Two Surgical Techniques in the Treatment of Gastroesophageal Reflux in Children

Nissen Fundoplication and Boix-Ochoa Antireflux Procedure: Comparison between Two Surgical Techniques in the Treatment of Gastroesophageal Reflux in Children

Gastric emptying of solids in normal children—a preliminary report

Babies with brain damage who can not swallow: surgical management

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