Comparison of laparoscopic Toupet and laparoscopic Nissen fundoplications in neurologically normal children

Miyano, Go; Yamoto, Masaya; Kaneshiro, Masakatsu; Morita, Keiichi; Nouso, Hiroshi; Koyama, Mariko; Okawada, Manabu; Doi, Takashi; Koga, Hiroyuki; Lane, Geoffrey J.; Fukumoto, Koji; Yamataka, Atsuyuki; Urushihara, Naoto

doi:10.1111/ases.12430

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…We prefer to be more conservative and perform conventional dissection and mobilization of the crura and esophagus because we are familiar with the outcome in both neurologically normal and impaired children. [1518] However, as more cases are treated minimally, a comparison of redos after conventional and minimal surgical intervention may become necessary. At present, we have no plan to change our orthodox approach.…”

Section: Discussionmentioning

confidence: 99%

A comparison of laparoscopic redo fundoplications for failed toupet and nissen fundoplications in children

Miyano

Yamoto

Morita

et al. 2019

J Indian Assoc Pediatr Surg

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Purpose:We compared laparoscopic redo fundoplications performed for failed laparoscopic Toupet fundoplication (LTF) and failed laparoscopic Nissen fundoplications (LNFs).Methods:Redo LTF (R-LTF; n = 4) and redo LNF (R-LNF; n = 6) performed between 2007 and 2014 were assessed retrospectively for severity of intraperitoneal adhesions on a scale of 0–3, identification/preservation of the anterior/posterior/hepatic branches of the vagus nerve (VN), complications, and outcome.Results:Redos were performed after a mean of 34 months in R-LTF and 32 months in R-LNF (P = ns) indicated for sliding hernia (n = 3; 2 with partial wrap dehiscence) and partial wrap dehiscence (n = 1) in R-LTF and sliding hernia (n = 6; 4 with partial wrap dehiscence) in R-LNF. The mean adhesion severity score was 1.5 in R-LTF and 2.5 in R-LNF (P < 0.05). The mean number of VN branches identified/preserved was 2.0 in R-LTF and 0.8 in R-LNF (P < 0.05). Mean operative times and mean blood loss were similar. Intraoperative complications were accidental local trauma (n = 1 in R-LTF and n = 3 in R-LNF, one requiring conversion to open repair) (P = ns). Gastric outlet obstruction developed in two R-LNF cases; both were managed conservatively. There have been no further recurrences to date.Conclusion:Although our series is small, adhesions were less, and identification/preservation of VN was easier during R-LTF.

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Section: Discussionmentioning

confidence: 99%