Can laparoscopic antireflux surgery improve the quality of life in children with neurologic and neuromuscular handicaps?

Kawahara, Hiroyuki; Okuyama, Hiroomi; Kubota, Akio; Oue, Takaharu; Tazuke, Yuko; Yagi, Makoto; Okada, Akira

doi:10.1016/j.jpedsurg.2004.08.034

Cited by 45 publications

(35 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ten percent with one redo undergo a second redo within three years. Others report similar failure rates between 12.5 and 20%, and the rate increases in redos [3][4][5][6].…”

Section: Discussionmentioning

confidence: 79%

“…There is significant heterogeneity among pediatric GERD studies [1]. Surgical treatment for GERD is reported to improve quality of life, especially for neurologically impaired children [2,3]. Despite initial symptomatic relief, however, the incidence of redo operation after fundoplication is reported between 1.7 and 18 percent [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Baerg¹,

Perrone²,

Vannix³

et al. 2016

Journal of Paediatrics and Neonatal Disorders

View full text Add to dashboard Cite

Objective:The aims were to compare outcome variables in children with gastroesophageal reflux disease (GERD) and one Nissen fundoplication to children with redo fundoplications and define the pediatric redo population. Methods:After IRB approval (#5100277), a case control study was conducted of children younger than 18 years, from two children's hospitals, with one Nissen fundoplication (control group) or a redo performed between January 1995 and March 2011. Complete data were collected by phone calls to caregivers in December 2012. Only redo operations performed after recurrence of GERD symptoms and wrap herniation into the mediastinum confirmed by contrast radiograph were included. To define the redo population, variables present before initial fundoplication, and outcome variables identified in December 2012, were compared. Continuous variables were analyzed by t-tests and categorical variables by chi-square tests. Logistic regression evaluated variable independence. Results:The families of 212 children were contacted (54% male), 181 had one fundoplication (85.4%) and 31 had redos (14.6%). The median follow-up time for controls was 3.6 years (range: 0.9-16 years). The median time to first redo was 17 months (range: 1-108 months) and to second redo for 3/31 (9.7%), it was 32.5 months (range: 23-69 months). A significantly greater number with redos, could not feed orally prior to undergoing their first Nissen fundoplication (p=0.003). At follow-up evaluation, children with redos had significantly more hospital admissions for pneumonia (p=0.02), vomiting and retching (p=0.01), gastrojejunal feeding tubes (p=0.01) and wrap herniation on contrast radiograph (p=0.01). Logistic regression revealed vomiting, OR: 3.4 (95% CI: 1.4-8.3) and retching, OR: 3.8 (95% CI: 1.6-9.2) were independently associated with the redo population. Conclusion:At follow-up evaluation, vomiting and retching are independent factors that define the redo population. Significantly more children with redos are fed by gastrojejunal feeding tubes because the redo fails to control their GERD symptoms. Abstract

show abstract

“…Ten percent with one redo undergo a second redo within three years. Others report similar failure rates between 12.5 and 20%, and the rate increases in redos [3][4][5][6].…”

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Baerg¹,

Perrone²,

Vannix³

et al. 2016

Journal of Paediatrics and Neonatal Disorders

View full text Add to dashboard Cite

show abstract

“…GOESSLER et al (10) observaram que a recurrência do refluxo teve correlação significativa com o grau de desnutrição encontrada no pré-operatório, sendo mais prevalente nos desnutridos graves. Alguns autores acreditam que o retardo do esvaziamento gástrico também pode contribuir para maior insucesso cirúrgico (7,29) , assim como episódios de convulsão, espasticidade e doenças respiratórias associadas, situações em que ocorreria aumento da pressão intra-abdominal, favorecendo anormalidades na fundoplicatura e retorno do refluxo (19,20) .…”

Section: Discussionunclassified

Evolução clínica e endoscópica após fundoplicatura para tratamento da doença do refluxo gastroesofágico

Vicente

Cardoso

Servidoni

et al. 2009

Arq. Gastroenterol.

View full text Add to dashboard Cite

RESUMO -Contexto -O tratamento cirúrgico da doença do refluxo gastroesofágico está indicado para pacientes com doença crônica, associada ou não a complicações. A fundoplicatura é frequentemente indicada em substituição ao uso contínuo dos inibidores de bomba de prótons, para pacientes sem resposta, resposta parcial, ou dependentes de tratamento medicamentoso, ou ainda, quando houver recurrência dos sintomas com a descontinuação das medicações. No período pós-operatório, ocorrências de desmanche da válvula com recurrência da doença do refluxo indicam a necessidade de monitorização do procedimento cirúrgico. A avaliação do funcionamento da válvula, baseada na presença de sintomas, tem se mostrado instrumento ineficaz para essa monitorização. Objetivo -Identificar a frequência de anormalidades na válvula antirrefluxo e a frequência de complicações pépticas do esôfago no período de pós-operatório tardio da fundoplicatura em crianças e adolescentes. Métodos -Em estudo transversal, prospectivo e descritivo, em que foram avaliados 45 pacientes (idade = 16 meses a 16,9 anos) que tinham realizado fundoplicatura de Nissen num período de 12 a 30 meses prévios à avaliação. O aspecto da fundoplicatura e da mucosa esofágica foram avaliados por meio de endoscopia digestiva alta e estudo histológico. Resultados -Doentes com encefalopatia crônica corresponderam a 26/45 (57,8%) dos casos. Válvula antirrefluxo intacta foi identificada em 41/45 (91,1%) dos pacientes. A fundoplicatura foi efetiva no tratamento do processo inflamatório esofágico, mesmo quando identificadas subestenose ou estenose de esôfago, no pré-operatório. As complicações identificadas foram esofagite péptica (6/45 pacientes) e necessidade de nova fundoplicatura (2/45 pacientes). A presença de anormalidades na válvula antirrefluxo associou-se ao achado de esofagite péptica (P = 0,005). Dois pacientes receberam o diagnóstico de esôfago de Barrett. Conclusão -A fundoplicatura pela técnica de Nissen se mostrou eficiente no controle das complicações esofágicas da doença do refluxo gastroesofágico. A endoscopia digestiva alta foi um exame útil na monitorização pós-operatória de crianças que realizaram fundoplicatura por doença do refluxo gastroesofágico. Permitiu avaliar a condição da válvula antirrefluxo e diagnosticar complicações relacionadas à recidiva da doença, mesmo em pacientes assintomáticos. DESCRITORES -Fundoplicatura. Refluxo gastroesofágico, cirurgia. Esofagite. Estenose esofágica. Esôfago de Barrett. Endoscopia gastrointestinal. Criança. INTRODUÇÃONa doença do refluxo gastroesofágico (DRGE), a passagem involuntária do conteúdo gástrico para o esôfago causa repercussão negativa sobre a saúde da criança (26) . Podem ocorrer alterações relacionadas à nutrição, à mucosa esofágica, à função respiratória ou ao aparecimento de sintomas neurocomportamentais (6) . Para as crianças com DRGE associada a complicações graves e/ou à doença crônica, as melhores opções terapêuticas são o tratamento medicamentoso com inibidor de bomba de prótons e a cirurgia antirrefluxo...

show abstract

“…Elimination of GOR occurs in almost all patients. Resolution or improvement of respiratory symptoms occurs in 48-92% of patients [101][102][103][104]. Four paediatric studies have specifically described the impact of fundoplication on respiratory symptoms and their results are summarised in table 4.…”

Section: Treatment Options Treatment Of Aspiration From Swallowing Dymentioning

confidence: 99%

“…Four paediatric studies have specifically described the impact of fundoplication on respiratory symptoms and their results are summarised in table 4. Recurrence of GOR occurs in ,10% of patients but repeat procedures are effective in almost all patients [103,[105][106][107][108]. Unfortunately, it is in children with neurological impairment or oesophageal dysmotility that there is a greater baseline incidence of both GOR and CPA, as well as a greater likelihood of failure of fundoplication (,27%) [101,103,105].…”

Section: Treatment Options Treatment Of Aspiration From Swallowing Dymentioning

confidence: 99%

Advances in the diagnosis and management of chronic pulmonary aspiration in children

Boesch

Daines

Willging

et al. 2006

European Respiratory Journal

158

141

View full text Add to dashboard Cite

Chronic pulmonary aspiration (CPA) in children is an important cause of recurrent pneumonia, progressive lung injury, respiratory disability and death. It is sporadic, intermittent and variable, and often occurs in children with complicated underlying medical conditions and syndromes that produce symptoms indistinguishable from CPA. For most types of aspiration there is no gold-standard diagnostic test. The diagnosis of CPA is currently made clinically with some supporting diagnostic evaluations, but often not until significant lung injury has been sustained. Despite multiple diagnostic techniques, the diagnosis or exclusion of CPA in children is challenging. This is of particular concern given the outcome of unrecognised progressive lung injury and the invasiveness of definitive therapies.Although new techniques have been introduced since the 1990s and significant advances in the understanding of dysphagia and gastro-oesophageal reflux have been made, characterisation of the aspirating child remains elusive.

show abstract

Can laparoscopic antireflux surgery improve the quality of life in children with neurologic and neuromuscular handicaps?

Cited by 45 publications

References 22 publications

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Outcomes after Pediatric Fundoplication: Defining the Redo Population

Evolução clínica e endoscópica após fundoplicatura para tratamento da doença do refluxo gastroesofágico

Advances in the diagnosis and management of chronic pulmonary aspiration in children

Contact Info

Product

Resources

About