Ann Surg Treat Res.  2025 Mar;108(3):177-185. 10.4174/astr.2025.108.3.177.

A single center experience on clinical outcome of fundoplication in pediatric patients: a retrospective cohort study

Affiliations
  • 1Department of Pediatric Surgery, Seoul National University Children’s Hospital, Seoul, Korea
  • 2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Purpose
The study aimed to evaluate the characteristics and operative-related factors in children who underwent fundoplication, analyze surgical outcomes categorized by disease entity and surgical indication, and identify prognostic factors for reoperation risk.
Methods
A total of 109 pediatric patients who underwent fundoplication between 2008 and 2022 were retrospectively analyzed. Patients were grouped by disease entity and surgical indication. Underlying diseases, comorbidities, sex, gestational age, birth weight, preoperative symptoms, and operation-related factors were examined. Outcomes were classified as short-term and long-term adverse events. We investigated differences in clinical outcomes according to disease entity and surgical indication. Then we statistically identified preoperative predictors for the risk of reoperation.
Results
The most common disease entity was neurological impairment (n = 92). Pulmonary comorbidity (42.2%) and aspiration/regurgitation (87.2%) were the most common. Most surgeries were performed laparoscopically (86.2%). There were 12 short-term and 25 long-term adverse events, with long-term events occurred more frequently in the neurological impairment (NIP) group compared to the non-NIP group (P = 0.04). None of the factors showed a significant relationship with the risk of reoperation.
Conclusion
Neurologically impaired children were more likely to experience long-term adverse events postfundoplication. However, no significant predictors for reoperation risk were identified.

Keyword

Child; Fundoplication; Gastroesophageal reflux; Pediatrics
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