Laparoscopic versus open fundoplication in infants

Sømme, Stig; Rodriguez, Jaime A.; Kirsch, David G.; Liu, D.C.

doi:10.1007/s00464-001-8147-1

Cited by 35 publications

(23 citation statements)

References 15 publications

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“…To date, research on open versus laparoscopic fundoplication often has relied on potentially nonrepresentative data typically drawn from a single center or hospital. [2][3][4][5] Although the results of previous studies suggest that the laparoscopic approach has concrete advantages over the open procedure, we do not know the degree to which they are generalizable. 6 Research on adults shows that the introduction of laparoscopic fundoplication in the early 1990s led to a substantial increase in total fundoplications.…”

mentioning

confidence: 95%

Outcomes of Laparoscopic Versus Open Fundoplication in Children's Hospitals: 2005–2008

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Fundoplication is the third most common major surgical procedure performed in children in the United States, and the laparoscopic approach has increased in popularity in the absence of strong evidence to support its adoption. WHAT THIS STUDY ADDS:In the study population, laparoscopic fundoplication was associated with shorter length of stay, reduced costs, and lower complication rates when compared with the open approach, even after adjustment for age and severity. OBJECTIVE:To compare infection rates, complication rates, length of stay, and cost for laparoscopic fundoplication versus open fundoplication among pediatric patients and to examine trends in utilization of laparoscopic fundoplication. METHODS:We used the Pediatric Health Information System database to conduct a retrospective study of children (aged Ͻ19 years) admitted for a fundoplication between 2005 and 2008. Descriptive characteristics for those undergoing a laparoscopic and open fundoplication were compared. Multivariate regression with random effects specified at the hospital level was used to model the association between laparoscopic fundoplication and the outcomes. RESULTS:Fifty-six percent of 7083 fundoplication admissions had laparoscopic fundoplication. Median length of stay was 4 days for laparoscopic and 10 days for open fundoplication. The median cost of laparoscopic fundoplication was $13 003 versus $22 487 for open fundoplication. Laparoscopic fundoplication was associated with a 24% and 51% reduction in the adjusted odds of infection and surgical complications, respectively. The proportion of fundoplications performed laparoscopically increased from 51% in 2005 to 63% in 2008 (P Ͻ .001), but there was no increase in the overall fundoplication rate. CONCLUSIONS: In a large study of children's hospitals, laparoscopic fundoplication was associated with improved outcomes compared with the open procedure, even after adjustment for patient severity. Laparoscopic fundoplication has become the most common form of antireflux surgery in children over 1 year of age, but this has not been associated with an increase in the overall utilization of the fundoplication procedure. These data have important implications for clinical practice and surgical training.

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confidence: 95%

Outcomes of Laparoscopic Versus Open Fundoplication in Children's Hospitals: 2005–2008

et al. 2011

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“…Laparoscopic fundoplication in comparison with open procedures is believed to decrease hospital length of stay, lead to earlier initiation of feeds, and allow for a quicker return to normal activity [7,11,13,14]. Diaz et al [15] also found a decrease in the number of acute complications in the laparoscopic approach.…”

Section: Discussionmentioning

confidence: 96%

“…Comparative studies between open and laparoscopic techniques, as seen in Table 1, group all children from ages 2 weeks to 18 years of age for analysis [11][12][13][14][15]. However, NICU patients that require antireflux and gastrostomy procedures are a unique population based on their size, prematurity, and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population

Thatch

Yoo

Arthur

et al. 2010

Journal of Pediatric Surgery

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“…Başarılı olan olgularda operasyondan sonra kilo alımı artar, özofajit, darlık ve solunum sistemine ait yakın-malarda gerileme olur. Aşağıda erişkin ve çocuklarda Nissen operasyonun nüks oranları özetlenmiştir (67)(68)(69)(70)(71)(72)(73).…”

Section: Sonuçlarunclassified

Esophageal Diseases In Children

Özcan¹

2012

Toraks Cer Bult

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ÖzetÇocuklarda özofagus hastalıkları arasında koroziv özofagus yaralanmaları önlenebilir bir hastalık olmasına rağmen günü-müzde halen önemli bir sağlık sorunudur. Sıklıkla evlerde temizlik için kullanılan kuvvetli bazik sıvıların küçük çocuklar tarafından kaza ile içilmesi sonucu özofagusta yanık ve ağır olgularda geç dönemde darlık ve buna bağlı yutma güçlüğü gelişir. Korozif özofagus darlıklarının standart tedavisi periyodik özofagus dilatasyonlarıdır. Bu dilatasyonlar yara iyileş-mesi süresi olan 1-2 yıl boyunca 3 haftada bir uygulanır. Bu süre sonunda yanıt alınamayan olgularda kolon ya da mide kullanılarak özofagus replasmanı yapılması gerekebilmektedir. Dilatasyon tedavisi dışında kalıp uygulamaları öneril-miş olsa da çocuklar için uygun kalıplar bulunmamaktadır. Çocuklarda koroziv özofagus darlıklarında mortalite nadir olmasına karşın, morbidite oldukça ciddidir ve hayat boyu süren sorunlar yaratabilir. Bu maddelerin paketlenmesi, etiketlenmesi ve kullanımını kısıtlayan kanuni hükümlere ve eğitime büyük ihtiyaç vardır.Çocuklarda yutma güçlüğü ile ortaya çıkan diğer bir özo-fagus hastalığı ise akalazyadır. Akalazya, alt özofagus sfinkteri dinlenme basıncının yüksekliği, yutma esnasında sfinkter gevşemesinde yetersizlik ve özofagus gövdesinde peristaltizm bozukluğu ile karakterize bir özofagus motilite hastalığıdır. Erişkin akalazyasından farklı olarak çocukluk yaş grubunda balon dilatasyon tedavisinin başarı şansı düşüktür, ayrıca tedavi sonunda gastroözofageal reflü gelişebilmek-tedir. Tedavide diğer bir seçenek olan laparoskopik Heller myotomi ise sfinkterdeki obstrüksiyonu tam olarak giderilebilmekte ayrıca ayni seansta eklenen parsiyel antireflü cerrahi prosedürler ile gastroözofageal reflü de önlenebilmektedir.

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Laparoscopic versus open fundoplication in infants

Cited by 35 publications

References 15 publications

Outcomes of Laparoscopic Versus Open Fundoplication in Children's Hospitals: 2005–2008

Outcomes of Laparoscopic Versus Open Fundoplication in Children's Hospitals: 2005–2008

A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population

Esophageal Diseases In Children

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