Laparoscopic vs open approach for the treatment of gastroesophageal reflux in children

Mattioli, Girolamo; Repetto, P.; Carlini, Claudio; Torre, Michele; Prato, Alessio Pini; Mazzola, Cinzia; Leggio, Samuele; Montobbio, Giovanni; Gandullia, Paolo; Barabino, A.; Cagnazzo, A.; Sacco, Oliviero; Jasonni, Vincenzo

doi:10.1007/s00464-001-9040-7

Cited by 50 publications

(35 citation statements)

References 7 publications

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“…In children, many diseases are treated laparoscopically, but only GERD has been evaluated on QoL outcomes. Mattioli et al [75] compared laparoscopic and open Nissen fundoplication in children aged 1-14 years (2b). Data on 66 children from an ad hoc questionnaire were analyzed.…”

Section: Gerd In Childhoodmentioning

confidence: 99%

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

et al. 2004

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Background: Measuring health-related quality of life (QoL) after surgery is essential for decision making by patients, surgeons, and payers. The aim of this consensus conference was twofold. First, it was to determine for which diseases endoscopic surgery results in better postoperative QoL than open surgery. Second, it was to recommend QoL instruments for clinical research. Methods: An expert panel selected 12 conditions in which QoL and endoscopic surgery are important. For each condition, studies comparing endoscopic and open surgery in terms of QoL were identified. The expert panel reached consensus on the relative benefits of endoscopic surgery and recommended generic and disease-specific QoL instruments for use in clinical research. Results: Randomized trials indicate that QoL improves earlier after endoscopic than open surgery for gastroesophageal reflux disease (GERD), cholecystolithiasis, colorectal cancer, inguinal hernia, obesity (gastric bypass), and uterine disorders that require hysterectomy. For spleen, prostate, malignant kidney, benign colorectal, and benign non-GERD esophageal diseases, evidence from nonrandomized trials supports the use of laparoscopic surgery. However, many studies failed to collect long-term results, used nonvalidated questionnaires, or measured QoL components only incompletely.

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Section: Gerd In Childhoodmentioning

confidence: 99%

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

et al. 2004

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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: 93%

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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“…However, the results in the case of supraesophageal symptoms are less satisfactory than in patients with typical manifestation of reflux [19][20][21].…”

Section: Discussionmentioning

confidence: 87%

“…Laparoscopic 360°floppy Nissen-Rossetti fundoplication was the procedure of choice [19][20][21]. Clinical status and parents' subjective evaluation was checked at 1, 3, 6, and 12 months.…”

Section: Methodsmentioning

confidence: 99%

Outcome of laparoscopic Nissen?Rossetti fundoplication in children with gastroesophageal reflux disease and supraesophageal symptoms

et al. 2004

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Laparoscopic vs open approach for the treatment of gastroesophageal reflux in children

Abstract: This study confirms that the minimally invasive approach is safe and effective for the treatment of primary gastroesophageal reflux disease in children.

Cited by 50 publications

References 7 publications

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery

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

Outcome of laparoscopic Nissen?Rossetti fundoplication in children with gastroesophageal reflux disease and supraesophageal symptoms

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