Laparoscopic Nissen Fundoplication Versus Thal Fundoplication in Children: Comparison of Short-Term Outcomes

Kubiak, Rainer; Andrews, Jeffrey C; Grant, Hugh W.

doi:10.1089/lap.2010.0218

Cited by 18 publications

(17 citation statements)

References 21 publications

(35 reference statements)

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“…Only two RCTs were identified, and only five articles used control groups to verify their results 6,8–10,14,23. Most studies used standardized surgical methods and investigation techniques and reported adequate on lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

The Effects and Efficacy of Antireflux Surgery in Children with Gastroesophageal Reflux Disease: A Systematic Review

Mauritz

Herwaarden-Lindeboom

Stomp

et al. 2011

Journal of Gastrointestinal Surgery

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BackgroundAntireflux surgery (ARS) for gastroesophageal reflux disease (GERD) is one of the most frequently performed major operations in children. Many studies have described the results of ARS in children, however, with a wide difference in outcome. This study aims to systematically review the efficacy of pediatric ARS and its effects on gastroesophageal function, as measured by gastroesophageal function tests. This is the first systematic review comprising only prospective, longitudinal studies, minimizing the risk of bias.MethodsThree electronic databases (Medline, Embase, and the Cochrane Library) were searched for prospective studies reporting on ARS in children with GERD.ResultsIn total, 17 eligible studies were identified, reporting on a total of 1,280 children. The median success rate after ARS was 86% (57–100%). The success rate in neurologically impaired children was worse in one study, but similar in another study compared to normally developed children. Different surgical techniques (total versus partial fundoplication, or laparoscopic versus open approach) showed similar reflux recurrence rates. However, less postoperative dysphagia was observed after partial fundoplication and laparoscopic ARS was associated with less pain medication and a shorter hospital stay. Complications of ARS varied from minimal postoperative complications to severe dysphagia and gas bloating. The reflux index (RI), obtained by 24-h pH monitoring (n = 8) decreased after ARS. Manometry, as done in three studies, showed no increase in lower esophageal sphincter pressure after ARS. Gastric emptying (n = 3) was reported either unchanged or accelerated after ARS. No studies reported on barium swallow x-ray, endoscopy, or multichannel intraluminal impedance monitoring before and after ARS.ConclusionARS in children shows a good overall success rate (median 86%) in terms of complete relief of symptoms. Efficacy of ARS in neurologically impaired children may be similar to normally developed children. The outcome of ARS does not seem to be influenced by different surgical techniques, although postoperative dysphagia may occur less after partial fundoplication. However, these conclusions are bound by the lack of high-quality prospective studies on pediatric ARS. Similar studies on the effects of pediatric ARS on gastroesophageal function are also very limited. We recommend consistent use of standardized assessment tests to clarify the effects of ARS on gastroesophageal function and to identify possible risk factors for failure of ARS in children.

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Section: Resultsmentioning

confidence: 99%

The Effects and Efficacy of Antireflux Surgery in Children with Gastroesophageal Reflux Disease: A Systematic Review

Mauritz

Herwaarden-Lindeboom

Stomp

et al. 2011

Journal of Gastrointestinal Surgery

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“…[2][3][4][5] However, there is little information on the long-term treatment outcomes of hiatal hernia in children. There are two main laparoscopic antireflux fundoplications that are currently performed: the "total wrap" technique, such as a Nissen fundoplication and the modified Nissen-Rossetti fundoplication, and the "partial wrap" technique, such as the Thal fundoplication and the Toupet fundoplication.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication versus Thal fundoplication in children with esophageal hiatal hernia: a retrospective report from two children’s medical centers in Shanghai

et al. 2015

World J Pediatr

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There was no statistical difference of recurrence between laparoscopic Nissen-Rossetti and Thal fundoplication in the long-term outcomes. The rate of slight dysphagia was higher in the Nissen-Rossetti group. The Thal group had a significantly higher recurrence rate of gastroesophageal reflux. There still exited learning curve for this procedure. The incidence rate of complications is significantly related to the proficiency of pediatric surgeon.

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“…Kubiak et al [17] reported dysphagia rates of 13.5% and 11.6% for each respective fundoplication, but the rates of severe dysphagia for Nissen and Thal were 10.1% and 1.7%, respectively (P = 0.018) in that study. In our current study, we experienced only one dysphagia cases among the HH patients.…”

Section: Discussionmentioning

confidence: 71%

“…Nissen fundoplication is the most widely performed but is associated with a high incidence of postoperative dysphagia and an appreciable recurrence rate in children with disabilities [13,14,15,16]. Thal is a partial wrap and is also widely performed, and is reported to be a simple and safe operative treatment in children with fewer perioperative complications and better long-term outcomes [17,18]. Surgical outcomes of both Thal and Nissen fundoplications as additional antireflux procedures for HH were good among our current study patients and there was no recurrence of HH in this series.…”

Section: Discussionmentioning

confidence: 99%

Hiatal hernia in pediatric patients: laparoscopic versus open approaches

Namgoong

Kim

et al. 2014

Ann Surg Treat Res

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PurposeThe aim of this study was to evaluate the surgical outcomes of laparoscopic approach for hiatal hernia (HH) in pediatric patients.MethodsThis was a retrospective study of 33 patients younger than 18 years who underwent an operation for HH between January 1999 and December 2012.ResultsThe HH symptoms were various and included regurgitation, vomiting, weight loss, cough, hoarseness, and cyanosis. Among the 33 patients, there were 25 sliding types, 1 paraesophageal type, and 7 mixed types. Open surgery (OS) and laparoscopic surgery (LS) were used in 16 and 17 patients, respectively. There were no statistically significant differences in sex, age, or body weight between the groups. The median operating time was longer in the LS group (150 minutes; range, 90-250 minutes vs. 125 minutes; range, 66-194 minutes; P = 0.028). Time to oral intake was shorter in the LS group than in the OS group (1 day; range, 1-3 days vs. 2 days; range, 1-7 days; P = 0.001) and time to full feeding was shorter in the LS group than in the OS group (6 days; range, 3-16 days vs. 10 days; range, 3-33 days; P = 0.048). There were no differences in length of hospital stay and complications between the two groups. There was no perioperative mortality or recurrence of HH.ConclusionA good surgical outcome for laparoscopic correction of HH was seen in pediatric patients.

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Laparoscopic Nissen Fundoplication Versus Thal Fundoplication in Children: Comparison of Short-Term Outcomes

Cited by 18 publications

References 21 publications

The Effects and Efficacy of Antireflux Surgery in Children with Gastroesophageal Reflux Disease: A Systematic Review

The Effects and Efficacy of Antireflux Surgery in Children with Gastroesophageal Reflux Disease: A Systematic Review

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication versus Thal fundoplication in children with esophageal hiatal hernia: a retrospective report from two children’s medical centers in Shanghai

Hiatal hernia in pediatric patients: laparoscopic versus open approaches

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