Randomized Controlled Trial of Laparoscopic and Open Nissen Fundoplication in Children

Fyhn, Thomas J.; Knatten, Charlotte Kristensen; Edwin, Bjørn; Schistad, Ole; Aabakken, Lars; Kjosbakken, Heidi; Pripp, Are Hugo; Emblem, Ragnhild; Björnland, Kristin

doi:10.1097/sla.0000000000001045

Cited by 38 publications

(34 citation statements)

References 46 publications

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“…In adult practice, laparoscopic fundoplication is considered the standard for proton pump inhibitor (PPI)‐resistant GORD, confirmed by a high‐quality RCT. Only a handful of RCTs focusing on ARS exist in the paediatric literature; these compared classical open versus laparoscopic fundoplication and wrap technique. Even these level 1 studies (according to the Oxford Centre for Evidence‐Based Medicine) did not report investigations for, and objective measures of, GORD both before and after operation.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…21 The laparoscopic approach has been associated with a lower incidence of retching, shorter length of stay, and less morbidity, but a higher cost and longer operative times. 5, [22][23][24][25][26] Some authors have also reported a higher rate of recurrence of GERD in the laparoscopic approach compared with the open approach. 5, 23,27 In the past 5 years, there has been one prospective randomized trial comparing recurrence of GERD in children for the two approaches.…”

Section: Discussionmentioning

confidence: 99%

“…5, [22][23][24][25][26] Some authors have also reported a higher rate of recurrence of GERD in the laparoscopic approach compared with the open approach. 5, 23,27 In the past 5 years, there has been one prospective randomized trial comparing recurrence of GERD in children for the two approaches. 23 Eighty-seven children were randomized, and at a median follow-up of 4 years, more patients in the laparoscopic fundoplication (LF) group (37%) experienced recurrence of GERD compared with the open fundoplication (OF) group (7%).…”

Section: Discussionmentioning

confidence: 99%

“…5, 23,27 In the past 5 years, there has been one prospective randomized trial comparing recurrence of GERD in children for the two approaches. 23 Eighty-seven children were randomized, and at a median follow-up of 4 years, more patients in the laparoscopic fundoplication (LF) group (37%) experienced recurrence of GERD compared with the open fundoplication (OF) group (7%). In another recent report, the authors evaluated the 4-year results following a randomized controlled trial comparing OF and LF in 31 children.…”

Section: Discussionmentioning

confidence: 99%

“…Complications of fundoplication include dysphagia from a wrap that is too tight, retching, gas bloat syndrome, breakdown of the wrap, hiatal herniation, slipped wrap, and recurrence of reflux. 18,23,36,37 Recurrence of GERD is <10 to 20%. 2 Risk factors for recurrence include younger age at the time of surgery, presence of a preoperative hiatal hernia, postoperative retching, and the need for postoperative esophageal dilations.…”

Section: Redo Fundoplicationmentioning

confidence: 99%

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Laparoscopic Fundoplication for the Surgical Management of Gastroesophageal Reflux Disease in Children

Dekonenko

Holcomb

2020

Eur J Pediatr Surg

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Gastroesophageal reflux (GER) is common in infants generally resolving in early childhood. However, gastroesophageal reflux disease (GERD) is diagnosed when persistent troublesome symptoms and/or complications of GER develop. These symptoms and complications can significantly affect the quality of life, thus requiring medical or surgical treatment. Medical management is typically trialed, but operative treatment is indicated with severe symptoms such as aspiration pneumonia, apneic episodes, bradycardia, apparent life-threatening events, severe vomiting, failure to thrive, esophagitis, stricture, and failed medical therapy. We review the recent literature on the indications and outcomes for laparoscopic fundoplication in the management of pediatric GERD.

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Scientific surgery

2015

British Journal of Surgery

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Randomized Controlled Trial of Laparoscopic and Open Nissen Fundoplication in Children

Abstract: Children operated with LF have a higher recurrence rate of GERD than those operated with OF.

Cited by 38 publications

References 46 publications

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

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

Laparoscopic Fundoplication for the Surgical Management of Gastroesophageal Reflux Disease in Children

Scientific surgery

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