Outcomes of Pediatric Laparoscopic Fundoplication: A Critical Review of the Literature

Martin, Kathryn; Deshaies, Catherine; Emil, Sherif

doi:10.1155/2014/738203

Cited by 36 publications

(20 citation statements)

References 47 publications

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“…Until specific investigations are instituted for all children suspected of GERD, both before initial fundoplication and at evaluation for wrap failure, questions will persist regarding fundoplication outcomes [1]. Similar to others, we found mortality after one fundoplication or redo is due to pneumonia and respiratory failure [23].…”

Section: Volume 1 | Issuesupporting

confidence: 80%

“…Surgeons perform fundoplication based on clinical criteria and center specific practice. [1,7,8,19] To strengthen the analysis in this study, however, all included children have an UGI contrast study at follow-up evaluation. Only those who fail medical therapy and have wrap herniation on contrast radiograph prior to redo are included as redo fundoplications.…”

Section: Volume 1 | Issuementioning

confidence: 99%

“…To clarify surgical indications, we recommend identification of clinical complications of GERD from a detailed history [1,7,24]. Many surgeons consider that no single study diagnoses GERD.…”

Section: Volume 1 | Issuementioning

confidence: 99%

“…Many surgeons consider that no single study diagnoses GERD. Children frequently undergo surgery for unclear indications, a consideration which our study supports [1,7,8]. We recommend a complete evaluation prior to proceeding with initial or redo fundoplication, including pH probe studies, endoscopy, contrast radiographs and videofluoroscopic swallowing studies [23,24].…”

Section: Volume 1 | Issuementioning

confidence: 99%

“…There is significant heterogeneity among pediatric GERD studies [1]. Surgical treatment for GERD is reported to improve quality of life, especially for neurologically impaired children [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes after Pediatric Fundoplication: Defining the Redo Population

Baerg¹,

Perrone²,

Vannix³

et al. 2016

Journal of Paediatrics and Neonatal Disorders

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Objective:The aims were to compare outcome variables in children with gastroesophageal reflux disease (GERD) and one Nissen fundoplication to children with redo fundoplications and define the pediatric redo population. Methods:After IRB approval (#5100277), a case control study was conducted of children younger than 18 years, from two children's hospitals, with one Nissen fundoplication (control group) or a redo performed between January 1995 and March 2011. Complete data were collected by phone calls to caregivers in December 2012. Only redo operations performed after recurrence of GERD symptoms and wrap herniation into the mediastinum confirmed by contrast radiograph were included. To define the redo population, variables present before initial fundoplication, and outcome variables identified in December 2012, were compared. Continuous variables were analyzed by t-tests and categorical variables by chi-square tests. Logistic regression evaluated variable independence. Results:The families of 212 children were contacted (54% male), 181 had one fundoplication (85.4%) and 31 had redos (14.6%). The median follow-up time for controls was 3.6 years (range: 0.9-16 years). The median time to first redo was 17 months (range: 1-108 months) and to second redo for 3/31 (9.7%), it was 32.5 months (range: 23-69 months). A significantly greater number with redos, could not feed orally prior to undergoing their first Nissen fundoplication (p=0.003). At follow-up evaluation, children with redos had significantly more hospital admissions for pneumonia (p=0.02), vomiting and retching (p=0.01), gastrojejunal feeding tubes (p=0.01) and wrap herniation on contrast radiograph (p=0.01). Logistic regression revealed vomiting, OR: 3.4 (95% CI: 1.4-8.3) and retching, OR: 3.8 (95% CI: 1.6-9.2) were independently associated with the redo population. Conclusion:At follow-up evaluation, vomiting and retching are independent factors that define the redo population. Significantly more children with redos are fed by gastrojejunal feeding tubes because the redo fails to control their GERD symptoms. Abstract

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Section: Volume 1 | Issuesupporting

confidence: 80%

Section: Volume 1 | Issuementioning

confidence: 99%

Section: Volume 1 | Issuementioning

confidence: 99%

Section: Volume 1 | Issuementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Baerg¹,

Perrone²,

Vannix³

et al. 2016

Journal of Paediatrics and Neonatal Disorders

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Efficacy of antireflux surgery in children with or without neurological impairment: a systematic review

Cullis

Siminas

Losty

2020

British Journal of Surgery

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Background: Antireflux surgery is commonly performed in children, yet evidence for its efficacy is limited. The aim of this review was to determine the effect of antireflux surgery with regard to objective measures of quality of life (QoL) and value of upper gastrointestinal investigations in neurologically normal (NN) and neurologically impaired (NI) children. Methods: A systematic review was conducted of articles reporting children undergoing antireflux surgery in whom preoperative and postoperative objective testing was performed. Primarily, Embase, CINAHL, MEDLINE and PubMed were searched from inception to April 2019. Methodological Index for Non-randomized Studies (MINORS) criteria were used to assess article quality. Results: Of 789 articles, 14 met the eligibility criteria, 12 prospective observational and 2 retrospective studies. The median MINORS score was 59⋅4 (i.q.r. 39 to 62⋅5) per cent. Seven studies reported assessment of validated QoL measures before and after antireflux surgery in 148 children. Follow-up ranged from 1 to 180 months. All studies confirmed significant improvements in QoL measures among NN and NI children at all follow-up points. Eleven studies reported on preoperative and postoperative investigations in between 416 and 440 children children. Follow-up ranged from 0⋅5 to 180 months. Nine studies confirmed improvements in gastro-oesophageal reflux using 24-h oesophageal pH monitoring with or without manometry, but conflicting results were identified for four studies reporting gastric emptying. No studies reported fluoroscopy or endoscopy adequately. Conclusion: Based on the results of studies of low-to-moderate quality, antireflux surgery improved QoL and reduced oesophageal acid exposure in NN and NI children in the short and medium term. Although antireflux surgery is a common elective operation, the lack of rigorous preoperative and postoperative evaluation(s) in the majority of patient-reported studies is striking.

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Nutrition support in children with medical complexity and chronic critical illness: A narrative review

Perez,

Graham,

Mehta

et al. 2024

Nut in Clin Prac

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Children with medical complexity (CMC) and children with chronic critical illness (CCI) represent growing populations with high healthcare use and dependence on specialized care, both in the hospital and community setting. Nutrition assessment and delivery represent critical components of addressing the short‐term and long‐term health needs for these populations across the care continuum. This article provides a framework and reviews existing literature for the assessment of nutrition status and subsequent delivery of nutrition prescriptions in CMC and children with CCI. The specific aims are to (1) describe the epidemiology of health services experience for CMC and children with CCI, with a focus on their nutrition outcomes; (2) detail how to assess their nutrition status and energy requirements; (3) review methods of delivery of the nutrient prescription; (4) introduce perioperative considerations; (5) highlight examples of special populations of CMC and children with CCI; and (6) propose future research initiatives to improve nutrition and overall outcomes for these populations.

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Outcomes of Pediatric Laparoscopic Fundoplication: A Critical Review of the Literature

Abstract: The level and quality of the evidence supporting laparoscopic fundoplication are extremely poor. Higher-quality data are required before the procedure can be considered to be an effective intervention in the treatment of pediatric GERD.

Cited by 36 publications

References 47 publications

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Efficacy of antireflux surgery in children with or without neurological impairment: a systematic review

Nutrition support in children with medical complexity and chronic critical illness: A narrative review

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