Laparoscopic gastroesophageal dissociation in neurologically impaired children with gastroesophageal reflux disease

DeAntonio, Jonathan H.; Parrish, Dan W.; Rosati, Shannon F.; Oiticica, Claudio; Lanning, David A.

doi:10.1016/j.jpedsurg.2017.10.010

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…The fragile nature of the NI patients renders time under anaesthesia of special relevance. Not all studies for laparoscopic-assisted and robotic TOGD have commented on surgical operating time [14,15]; however, operating time for Laparoscopic TOGD has been reported up to 400 min [8]. Our three cases of M-OGD have averaged 200 min, that compares well with the 250 min for a classical TOGD [16].…”

Section: Commentssupporting

confidence: 58%

“…TOGD has been used more commonly in Europe [5][6][7], but there are only limited reports for this approach in the United States [8,9] or other non-EU [10,11] countries. However, for a very specific and complex patient population, this procedure has a high likelihood of permanently eliminating recurrent reflux and aspiration, and of improving the quality of life for the patients and their caregivers by reducing healthcare visits and hospital readmissions, and improving feeding habits [12].…”

Section: Commentsmentioning

confidence: 99%

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Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

et al. 2020

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Adhesions and fibrosis following failed primary surgery for severe gastro-oesophageal reflux (GOR) in neurologically impaired children (NI) can render mobilization of the lower oesophagus and oesophago-jejunal anastomosis a technically demanding exercise both at open surgery and laparoscopy. This paper presents the Modified Oesophago-Gastric Dissociation (M-OGD) as a less complex technical modification of the original Total Oesophago-Gastric Dissociation (TOGD). The stomach is detached from the oesophago-gastric junction with an articulated 5-mm stapler, leaving a 5-mm strip of stomach attached to the oesophagus. An end-to-side isoperistaltic oesophago-jejunostomy is created between the gastric stump and the isoperistaltic jejunal Roux loop. A jejuno-jejunal anastomosis restores bowel continuity. Between May 2018 and February 2020, M-OGD was performed on 3 NI patients with a weight of 9–27.3 kg (median = 14 kg). Median age at surgery was 60 months (18–180), median surgical time 170 min (146–280), median re-feeding time was 3 days (2–5), and median length of stay was 20 days (11–25). All patients healed primarily and after a median follow-up of 3 months, there were no problems related to the oesophago-jejunal anastomosis. M-OGD reduces the difficulties of redo oesophageal surgery following failed anti-reflux procedures, with a safer oesophago-jejunal anastomosis and a good long-term outcome.

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Section: Commentssupporting

confidence: 58%

Section: Commentsmentioning

confidence: 99%

Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

et al. 2020

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“…), reduced lung reserve caused by recurrent lung infections (fig. 2), epilepsy which causes wrap dehiscence, and migration are only some of such difficulties (15,16). During open or laparoscopic Nissen fundoplication in NIC with GERD, extreme abdominal wall deformities and limb contractures are usual challenges limiting the exposure of the esophageal hiatus and the dissection of the intrathoracic esophagus essential for a successful surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Gastroesophageal reflux disease (GERD) is a common and important gastrointestinal tract disease of childhood (1,2). Neurologically impaired children (NIC) have an increased risk for GERD and GERD dependent comorbidities, such as recurrent upper and lower respiratory tract infections, severe feeding and growth (3). Serious neurological damages in these children result in frequent emergency service visits and persistent pulmonary problems, such as persistent coughing, asthma, apnea and apparent life-threatening situations (4).…”

Section: Introductionmentioning

confidence: 99%

“…While recurrence rates after open or laparoscopic Nissen Fundoplication in non-NIC have been reported as 2-5%, they were reported as high as 45% in NIC. Therefore, surgical treatment of GERD in NIC is still a significant challenge for surgeons and patients (3,6,7). Laparoscopic anti-reflux surgery is still the first preferred technique in children (5).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of robotic assisted laparoscopic nissen fundoplication in neurologically impaired children with severe gastroesophageal reflux disease

BAHADIR¹,

Arslan²,

ÇALIŞKAN³

et al. 2022

J. Exp. Clin. Med.

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Laparoscopic Nissen Fundoplication is still the most widely used surgical technique in the treatment of gastroesophageal reflux disease (GERD) in children. However, there are some technical and anatomical difficulties in the treatment of reflux in NIC with GERD. All these difficulties lead to the high rate of surgical failure observed in neurological impaired children (NIC). Robotic surgery provides several advantages in overcoming these difficulties. This study is the first study to evaluate the effectiveness of robotic surgery in the treatment of GERD in children with severe or moderate neurological impairments reported in Turkey. This study took place between January 2018 and February 2020. We retrospectively evaluated the records of eleven children with severe or moderate neurological problems who were treated using the robotically assisted laparoscopic Nissen fundoplication (RALNF) technique for demographic data, anesthesia time, pre-console time, console time, and postoperative complications. Nine of the patients (81.8%) had serious and two had moderate neurological problems. All of the patients applied to the emergency department at different times due to recurrent lung infections. While the first RALNF console time was 240 minutes, this study revealed that this time decreased to 45 minutes. None of the patients had complications related to the surgical procedure, but four patients required postoperative intensive care unit up to two months due to several problems related to NIC. RALNF can be safely applied to pediatric patients with GERD with severe and moderate NIC.

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Gastroösophagealer Reflux bei Kindern und Jugendlichen

Muensterer¹

2018

Kinderchirurgie

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Laparoscopic gastroesophageal dissociation in neurologically impaired children with gastroesophageal reflux disease

Cited by 8 publications

References 16 publications

Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

Modified Oesophago-Gastric Dissociation (M-OGD) — a technical modification

Effectiveness of robotic assisted laparoscopic nissen fundoplication in neurologically impaired children with severe gastroesophageal reflux disease

Gastroösophagealer Reflux bei Kindern und Jugendlichen

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