Outcomes of laparoscopic nissen fundoplications in children younger than 2-years: single institution experience

被引:4
作者
Rosales, Armando [1 ]
Whitehouse, Jill [2 ]
Laituri, Carrie [2 ]
Herbello, Glenda [2 ]
Long, Julie [2 ]
机构
[1] Cleveland Clin Florida, Dept Surg, Weston, FL USA
[2] Joe DiMaggio Childrens Hosp, Dept Pediat Surg, 1150 N 35th Ave,Suite 555, Hollywood, FL 33021 USA
关键词
Laparoscopic; Nissen; Fundoplication; Gastroesophageal reflux; GASTROESOPHAGEAL-REFLUX DISEASE; ANTIREFLUX SURGERY; INFANTS; GASTROSTOMY; OPERATIONS; PLACEMENT; TUBE;
D O I
10.1007/s00383-018-4281-x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Variation exists in the diagnostic testing for gastroesophageal reflux (GER) in infants and in the application of surgical therapy. There has been an increase in antireflux surgery (ARS) since the development of laparoscopy but the outcomes in high-risk infants is unclear. This study examines the results of laparoscopic fundoplication in infants less than 2 years. The results of infants less than 2 years undergoing laparoscopic Nissen fundoplication (Lap-F) from 2012 to 2015 were retrospectively reviewed and outcomes were followed until 2017. There were 106 patients, median gestational age 32.50 weeks +/- 6.35 SD and non-corrected age at operation 23.0 weeks +/- 19.0 SD, mean weight of 4.81 kg +/- 2.10 SD. One of the most common reasons for surgical consultation was improvement in respiratory status after insertion of nasoduodenal feeding tube. Of the Lap-F, 100 were with gastrostomy tube (GT). There were no conversions to open or intraoperative complications. The complication rate was 4.71%, and the reoperation rate was 5.66%, one fundoplication revision and the others gastrostomy revisions. The median time for feeds and to reach goal were 1 (1-14) and 4 (2-279) days, respectively. The 30-day mortality was 0.9% and long-term it was 4.71%. The long-term mortality was related to the underlying medical problems. The median follow-up was 113 (3-286) weeks. One patient required revision of the fundoplication and none required esophageal dilatation during the follow-up period. Fundoplication is effective for relief of symptoms of GER in children younger than 2 years. The procedure has a low morbidity and mortality in this population.
引用
收藏
页码:749 / 754
页数:6
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