Abstract
Neurologically impaired children account for almost half of the fundoplication procedures performed for gastroesophageal reflux disease. Aim of the present study was to report results of antireflux surgery in neurologically impaired children. A retrospective study of neurologically impaired children who underwent fundoplication over a 13-year period (1999–2012) was performed. Recurrence rate, major complications and parents/caregivers perceptions of their child's quality of life following antireflux surgery were analyzed. A total of 122 children (median age: 8 years 9 months; range: 3 months to 18 years) had open “tension-free” Nissen fundoplication, gastrostomy + /− pyloroplasty. Gastroesophageal reflux disease was in all cases documented by at least two diagnostic exams. Median duration of follow-up was 9.7 (1.9–13) years. Three (2.4%) recurrences were documented and required surgery re-do. Major complications were 6%. Seventy-nine of 87 (90%) caregivers reported that weight gain was improved after fundoplication with a median score of 1 (IQR: 1–2). Significant improvement was perceived in postoperative overall quality of life. In this series of fundoplication recurrence incidence was low, serious complications were uncommon and caregivers’ satisfaction with surgery was high. Accurate patient’s selection and creating a “low-pressure” surgical system are mandatory to obtain these results.
Highlights
Impaired children account for almost half of the fundoplication procedures performed for gastroesophageal reflux disease
neurological impairment (NI) children constitute a great part of the population of patients who require surgery for gastroesophageal reflux disease (GERD)
The burden of GERD related problems is known to have significant psychosocial implications and adversely impacts on the quality of life of these children and their caregivers but there is a limited understanding of their impact on well-being and quality of life
Summary
Impaired children account for almost half of the fundoplication procedures performed for gastroesophageal reflux disease. Recurrence rate, major complications and parents/caregivers perceptions of their child’s quality of life following antireflux surgery were analyzed. Significant improvement was perceived in postoperative overall quality of life In this series of fundoplication recurrence incidence was low, serious complications were uncommon and caregivers’ satisfaction with surgery was high. Keeping in mind that reported rates of failure depend on definitions used and duration of follow-up, large contemporary series of FP report a requirement for re-do surgery in 15–30%4–7. This higher mortality, morbidity, surgical complication and re-operation rate leads to a reluctance on the part of some surgeons to undertake this procedure. Selection and preoperative criteria for tight indications to surgical treatment; Technical suggestions giving excellent results in term of complications and failure rate; Parent/caregiver perceptions of symptom following surgery, with evaluation of their attitude to surgical intervention
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
