Long-term and ‘patient-reported’ outcomes of total esophagogastric dissociation versus laparoscopic fundoplication for gastroesophageal reflux disease in the severely neurodisabled child

Total oesophago‐gastric dissociation in neurologically impaired children: Laparoscopic vs robotic approach

“…5 In neurologically impaired children, especially in ones affected by seizures, the risk of recurrence of GOR and mortality after a fundoplication is higher compared with patients with a normal neurological level. 1,2,[6][7][8][9][10][11] For this reason, in recent years, TOGD has obtained an higher consensus in the surgical treatment of GOR in this kind of patients. In fact, it is now considered as a valid option not only as a 'rescue' intervention in patients with recurrence of GOR after fundoplication, but also as primary procedure with good results.…”

“…The X-ray contrast study on postoperative day (7 POD) did not show the presence of complications in all the children of the laparoscopic group and in four children of the robotic one. In the boy with oesophageal atresia history and oesophageal perforation in presence of an on-lay mesh, the X-ray contrast study detected a dehiscence of the oesophago-jejunal anastomosis.In the laparoscopic group, the feeding restarted on POD 7 (range 5-11), while in the robotic group, on POD 8 (range[6][7][8][9][10][11][12][13]. Feeding of the patients usually began with clear liquid feedings through the gastrostomy.…”

Should the Gross Motor Function Classification System be used for children who do not have cerebral palsy?

“…Twenty‐nine papers used the GMFCS only to describe participants . Eleven other papers used the GMFCS only to define eligibility criteria . While reliability and validity of GMFCS have been demonstrated in children with CP, none of these articles reported reliability or validity of these GMFCS categorizations in other conditions/clinical descriptions.…”

“…Among the 118 papers, 76 did not mention that the GMFCS was developed specifically for use with children with CP or discuss its measurement properties . Twenty noted that the GMFCS was created for children with CP but did not justify its application to their condition/clinical description .…”

Total oesophagogastric dissociation for severe gastro‐oesophageal reflux in children with previous upper gastrointestinal surgery: A new route for an old tract

“…Total oesophagogastric dissociation (TOGD) has been reported as a salvage procedure when fundoplication fails. However, its role as a primary procedure for patients with severe GOR is underreported, despite previous studies demonstrating its superiority over fundoplication in terms of a lower failure rate and better quality of life . We herein report our experience of performing TOGD as the primary operation for GOR in two patients with previous upper gastrointestinal surgery who were considered high risk for failed fundoplication.…”