Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy

Durante, A; Schettini, Sergio Crescenzo Antonio; Fagundes, Djalma José

doi:10.1590/s1516-31802007000100004

Cited by 13 publications

(20 citation statements)

References 28 publications

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“…Nos últimos anos, as evidências demonstram que a expectativa de vida de pessoas com PC está aumentando e, em parte, isso se deve à melhoria dos cuidados nutricionais desses indivíduos 18,19 . É clara a necessidade de uma equipe interdisciplinar que tenha conhecimento dessas alterações e que seja capacitada para o tratamento adequado dessas condições, prevenindo as repercussões nutricionais e da saúde desses indivíduos.…”

Section: Introductionunclassified

Digestive tract neural control and gastrointestinal disorders in cerebral palsy

Araújo¹,

Silva²,

Mendes³

2012

J Pediatr (Rio J)

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Objectives: To examine the neural control of digestive tract and describe the main gastrointestinal disorders in cerebral palsy (CP), with attention to the importance of early diagnosis to an efficient interdisciplinary treatment.Sources: Systematic review of literature from 1997 to 2012 from Medline, Lilacs, Scielo, and Cochrane Library databases. The study included 70 papers, such as relevant reviews, observational studies, controlled trials, and prevalence studies. Qualitative studies were excluded. The keywords used were: cerebral palsy, dysphagia, gastroesophageal reflux disease, constipation, recurrent respiratory infections, and gastrostomy. Summary of the findings:The appropriate control of the digestive system depends on the healthy functioning and integrity of the neural system. Since CP patients have structural abnormalities of the central and peripheral nervous system, they are more likely to develop eating disorders. These range from neurological immaturity to interference in the mood and capacity of caregivers. The disease has, therefore, a multifactorial etiology. The most prevalent digestive tract disorders are dysphagia, gastroesophageal reflux disease, and constipation, with consequent recurrent respiratory infections and deleterious impact on nutritional status. Conclusions:Patients with CP can have neurological abnormalities of digestive system control; therefore, digestive problems are common. The issues raised in the present study are essential for professionals within the interdisciplinary teams that treat patients with CP, concerning the importance of comprehensive anamnesis and clinical examination, such as detailed investigation of gastrointestinal disorders. Early detection of these digestive problems may lead to more efficient rehabilitation measures in order to improve patients' quality of life.J Pediatr (Rio J). 2012;88(6):455-64: Cerebral palsy, dysphagia, gastroesophageal reflux disease, constipation. ResumoObjetivos: Abordar as peculiaridades do controle neuronal digestório e descrever as principais manifestações digestórias na paralisia cerebral, atentando-se à importância do diagnóstico precoce para intervenção interdisciplinar eficaz. Fontes dos dados:Revisão sistemática de 1997 a 2012 das bases de dados MEDLINE, LILACS, SciELO e Cochrane Library. Incluem-se 70 artigos, como revisões relevantes, estudos observacionais, ensaios clínicos e estudos de prevalência. Excluíram-se pesquisas qualitativas. Os termos pesquisados foram: paralisia cerebral, disfagia, doença do refluxo gastroesofágico, constipação intestinal, infecção respiratória e gastrostomia. Síntese dos dados:O controle adequado do trato digestório depende do funcionamento e integridade do sistema nervoso. Como indivíduos portadores de paralisia cerebral possuem anormalidades estruturais evidentes no sistema nervoso central e periférico, estão mais propensos a desenvolver distúrbios do trato digestório, com repercussões nutricionais. As alterações vão desde imaturidade neurológica até interferência do estado d...

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Section: Introductionunclassified

Digestive tract neural control and gastrointestinal disorders in cerebral palsy

Araújo¹,

Silva²,

Mendes³

2012

J Pediatr (Rio J)

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“…Phase I of screening identified 83 potentially eligible articles; Phase II identified 14 studies to be included in the final analysis: 2 randomized controlled trials (RCT) [20], [21] and 12 retrospective cohort studies [22]–[33] (Figure 1). …”

Section: Resultsmentioning

confidence: 99%

“…The most common partial fundoplications were the Thal (7/14 studies) [21], [23], [26]–[29], [31] and Toupet (5/14) [22], [25], [26], [28], [33]. The other partial techniques used included the Watson (1/14) [32], Boix-Ochoa (2/14) [24], [30], and Vertical Gastric Plication (1/14) [20].…”

Section: Resultsmentioning

confidence: 99%

Partial versus Complete Fundoplication for the Correction of Pediatric GERD: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundThere is no consensus as to what extent of “wrap” is required in a fundoplication for correction of gastroesophageal reflux disease (GERD).ObjectiveTo evaluate if a complete (360 degree) or partial fundoplication gives better control of GERD.MethodsA systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Screening identified those comparing techniques. The primary outcome was recurrence of GERD following surgery. Dysphagia and complications were secondary outcomes of interest. Meta-analysis was performed when appropriate. Study quality was assessed using the Cochrane Risk of Bias Tool.Results2289 abstracts were screened, yielding 2 randomized controlled trials (RCTs) and 12 retrospective cohort studies. The RCTs were pooled. There was no difference in surgical success between partial and complete fundoplication, OR 1.33 [0.67,2.66]. In the 12 cohort studies, 3 (25%) used an objective assessment of the surgery, one of which showed improved outcomes with complete fundoplication. Twenty-five different complications were reported; common were dysphagia and gas-bloat syndrome. Overall study quality was poor.ConclusionsThe comparison of partial fundoplication with complete fundoplication warrants further study. The evidence does not demonstrate superiority of one technique. The lack of high quality RCTs and the methodological heterogeneity of observational studies limits a powerful meta-analysis.

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“…By starting the stapled division from the greater curvature of the stomach, we are able to achieve a line of gastric division that is appropriate for the size of the patient. This is preferable to the constraint of transverse anastomosis staplers used in the VGP [11,12,19,20]. In addition, this may prevent the staple line dehiscence that plagued bariatric operations such as the vertical banded gastroplasty [21].…”

Section: Discussionmentioning

confidence: 99%