Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

Abstract

For children with primary GERD, LNF is a long-term efficient procedure. For the neurologically impaired children, the results were good, with more than 85% of the children symptom free after 5 years, although repeated evaluations are required to diagnose late recurrences related to evolving dysmotility disorders.

Laparoscopic Toupet fundoplication for gastroesophageal reflux: a series of 131 neurologically impaired pediatric cases at a single children’s hospital

“…There also seem to be more reports of recurrence after LNF. Although the recurrence rate in our series was low compared with other reports in the literature [15,[18][19][20], we were not able to compare LTF with LNF in this series because of sample size discrepancy. As belching is known to be associated with easing unwanted reflex coughing, gas bloat syndrome, and respiratory problems [21], the Toupet fundoplication would seem to suppress pressure build-up around the cardia which prevents suture dehiscence and slipping that could cause recurrence of GERD.…”

Laparoscopic fundoplication for gastroesophageal reflux disease in infants and children

“…1 On the other hand, wrap migrations occurred more frequently in neurologically impaired children and those with postoperative esophageal atresia and diaphragmatic hernia. 1,35,36 In our series of 26 wrap migrations in neurologically normal children, there were 2 (7.7%) failures, but one had postoperative long-gap esophageal atresia and the other had tracheal stenosis (Table 2). Among the procedures, there was no difference in the ratio of redo surgery in neurologically normal children, 33 but the use of esophago-crural sutures and minimal esophageal dissection reduced the incidence of the postoperative transmigration of an LNF wrap.…”

The management of scoliosis in children with cerebral palsy: a review

“…Gastro-esophageal reflux disease (GORD) is present in up to 70% (48) of CP patients leading to a greatly enhanced risk of bronchopulmonary-aspiration (49), which is often significant on a background of poor respiratory reserve. Optimization of GORD in children with CP using surgical techniques such as fundoplication has been shown to be an effective way of controlling symptoms (50,51). However, the high risk of postoperative complications, morbidity and mortality from anti-reflux procedures must be considered (52)(53)(54).…”