J Korean Assoc Pediatr Surg.  2016 Dec;22(2):49-53. 10.13029/jkaps.2016.22.2.49.

Laparoscopic Nissen Fundoplication in Children with Neurological Impairment versus Neurologically Normal Children

• Joo Y
• Lee JY
• Choi JH
• Namgung JM
• Kim SC
• Kim DY

• KMID: 2363024
• DOI: http://doi.org/10.13029/jkaps.2016.22.2.49

Abstract

PURPOSE
This study aimed to assess the long-term clinical outcome of laparoscopic Nissen fundoplication (LNF) in children according to their neurologic status.
METHODS
The study retrospectively analyzed the data of 82 children (62 neurologically impaired and 20 neurologically normal children with primary gastroesophageal reflux disease) who had undergone LNF between 2003 and 2012. The main outcome measures were the occurrence of recurrence that required reoperation and post-procedure complications such as infections, pneumonia, and gastrointestinal complications including ileus, dysphagia, and delayed gastric emptying.
RESULTS
The median age at the time of the LNF was 25 months (range, 1-192 months), and the median of body weight was 10.0 kg (range, 2.8-37.0 kg). The average weight gain was 1.55±1.68 kg at 6 months, 3.32±2.30 kg at 1 year, and 5.63±4.22 kg at 2 years after surgery. Six (9.7%) of the 62 neurologically impaired patients and two (10.0%) of neurologically normal lost their body weight or had no weight changes. Eight (12.9%) of the 62 neurologically impaired children had required redo surgery because of gastroesophageal reflux disease recurrences, while 2 (10.0%) of the 20 neurologically normal children had experienced recurrences. In the neurologically impaired children, the postoperative complications included pneumonia (n=1), wound infection (n=1), urinary tract infection (n=1), dysphagia (n=1), delayed gastric emptying (n=1), and ileus (n=2). All of these complications were not found in the neurologically normal group, except for only one case of infectious colitis. However, there was no statistically significant difference between the two groups in postoperative complications.
CONCLUSION
The outcomes of laparoscopic fundoplication were similar in the neurologically impaired children and in the neurologically normal children.

Keyword

Gastroesophageal reflux; Laparoscopy; Fundoplication; Neurologic deficit

MeSH Terms

Body Weight
Child*
Colitis
Deglutition Disorders
Fundoplication*
Gastric Emptying
Gastroesophageal Reflux
Humans
Ileus
Laparoscopy
Neurologic Manifestations
Outcome Assessment (Health Care)
Pneumonia
Postoperative Complications
Recurrence
Reoperation
Retrospective Studies
Urinary Tract Infections
Weight Gain
Wound Infection

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