Late results of fundoplication for gastroesophageal reflux in infants and children. Surgery 1989 Apr;105(4):457-64
Date
04/01/1989Pubmed ID
2928949Scopus ID
2-s2.0-0024546068 (requires institutional sign-in at Scopus site) 83 CitationsAbstract
The Nissen fundoplication (NFP) for the management of severe gastroesophageal reflux (GER) in infants and children has become one of the most frequently performed operations in pediatric surgical centers in the United States. Short-term outcome, morbidity, and mortality are consistently favorable in several large series. The long-term success of this procedure is presumed but has not been established objectively. To examine the late results of this operation, 46 infants and children were carefully evaluated more than 5 years after NFP (mean, 6.7 years). Evaluation included parental interview, physical examination, upper gastrointestinal series, and esophageal pH monitoring. The mean age at the time of operation was 4.13 years. Fifty-seven percent of the patients had significant neurologic impairment, and 80% had at least one serious additional medical problem. Twenty-four percent of the children died during the period of follow-up--all but one death related to serious underlying medical problems. Of the 35 survivors, 26 (74.3%) have no symptoms; five (14.3%) have mild symptoms potentially referable to GER that necessitate little if any treatment; four (11.5%) have had symptomatic recurrence of GER necessitating repeat fundoplication. Three of these patients now have no symptoms. Forty-five percent of the patients had at least one postoperative complication. NFP provides efficacious, long-term treatment of GER in infants and children, with acceptable morbidity. Mortality in this group of children is related primarily to associated diseases rather than to GER.
Author List
Turnage RH, Oldham KT, Coran AG, Blane CEMESH terms used to index this publication - Major topics in bold
AdolescentChild
Child, Preschool
Evaluation Studies as Topic
Female
Gastroesophageal Reflux
Humans
Infant
Intraoperative Complications
Male
Postoperative Complications
Recurrence
