Anti-reflux surgery for gastroesophageal reflux in neurological impaired and non-impaired children: Long term outcomes after a median follow-up of more than ۱۰ years
Publish place: Journal of Surgery and Trauma، Vol: 8، Issue: 4
Publish Year: 1399
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_JSTR-8-4_003
تاریخ نمایه سازی: 5 دی 1402
Abstract:
Introduction: The durability of a fundoplication (FP) in the treatment of gastroesophageal reflux disease (GERD) in children must be confirmed in the long-term. This study aimed to present the long-term outcome after a minimum of five years.
Methods: Perioperative data were retrospectively reviewed from clinical records, and the follow-up data were collected through a standardized questionnaire. In total, ۲۱ neurologically impaired (NI) and nine neurologically non-impaired (NNI) children were included in this study. The statistical analysis was performed using SPSS software (version ۲۵) through Fisher’s exact test, t-test, and Kaplan-Meier analysis. A p-value of less than ۰.۰۵ was considered statistically significant.
Results: The median follow-up period was ۱۰.۸ years (۵-۱۹.۷), and the refundoplication rates ranged from ۱۱% to ۱۹%. Revisions were usually necessary within the first two postoperative years. Most delayed refundoplications were necessary for the NI children with a laparoscopic Nissen FP. In the long-term, symptoms and medication administration program were favorable in most cases. Most parents were highly satisfied with the postoperative outcome and would approve that FP is conducted on their child again under the same circumstances.
Conclusions: The FP is a safe procedure with consistent benefits in the first ۱۰ postoperative years in NI and NNI children with documented GERD. The NI children treated with a laparoscopic Nissen FP necessitate longer postoperative surveillance since more delayed redofundoplications were required in this group.
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Authors
Giovanni Frongia
MD, Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
Elena Jonas
MD, Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
Arianeb Mehrabi
MD, Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
Patrick Günther
MD, Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
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