Faculty Collaboration Database

Population-based comparison of open vs laparoscopic esophagogastric fundoplication in children: application of the Agency for Healthcare Research and Quality pediatric quality indicators. J Pediatr Surg 2011 Apr;46(4):648-654

Date

04/19/2011

Pubmed ID

21496532

DOI

10.1016/j.jpedsurg.2010.09.012

Scopus ID

2-s2.0-79954562274 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

BACKGROUND/PURPOSE: Increasing national focus on patient safety has promoted development of the pediatric quality indicators (PDIs), which screen for preventable events during provision of health care for children. Our objective is to apply these safety metrics to compare 2 surgical procedures in children, specifically laparoscopic and open esophagogastric fundoplication for gastroesophageal reflux.

METHODS: A retrospective analysis using 20 years of data from national representative state inpatient databases through the Healthcare Cost and Utilization Project was conducted. Patients younger than 18 years with International Classification of Diseases, Ninth Revision, Clinical Modification, codes for open or laparoscopic esophagogastric fundoplication were included. Pediatric quality indicators were linked to each patient's profile. Demographics, comorbidities, outcomes, and 8 selected PDIs between open and laparoscopic fundoplications were compared using Pearson χ(2) tests and t tests.

RESULTS: Of 33,533 patients identified, 28,141 underwent open and 5392 underwent laparoscopic fundoplication. Comorbidities occurred more frequently in open surgery. In-hospital mortality, length of stay, and hospital charges were less in laparoscopic surgery. Of the 8 PDIs evaluated, decubitus ulcer (P = .04) and postoperative sepsis (P = .003) had decreased rates with laparoscopic surgery compared with open.

CONCLUSION: Laparoscopic fundoplication for gastroesophageal reflux in children can be performed safely compared with the open approach with equivalent or improved rates of PDIs.

Author List

Rhee D, Zhang Y, Chang DC, Arnold MA, Salazar-Osuna JH, Chrouser K, Colombani PM, Abdullah F

Author

Jose Salazar Osuna MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Cost of Illness
Female
Fundoplication
Gastroesophageal Reflux
Humans
Infant
Infant, Newborn
Laparoscopy
Laparotomy
Male
Quality Indicators, Health Care
Retrospective Studies
United States
United States Agency for Healthcare Research and Quality