Nissen Fundoplication for Gastro-Esophageal Reflux in Repaired Tracheo-Esophageal Fistula

Mt, Corbally; Muftah, Mayssan; Ej, Guiney

doi:10.1055/s-2008-1063472

Cited by 16 publications

(7 citation statements)

References 1 publication

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“…The recurrence rate following redo Nissen fundoplication in our series is higher for NI children (48%). Different studies have documented that the results of the first fundoplication are negatively influenced by the presence of neurological impairment and associated anomalies, both in children [6,8,[20][21][22][23][24], and infants [25] and several authors [24][25][26][27][28][29][30] have reported that the fundoplication is associated with a higher recurrence rate in patient with repaired oesophageal atresia (up to 24%). Associated anomalies were present in about 50% of the patients that required redo fundoplication.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting failure of redo Nissen fundoplication in children

et al. 2007

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Recurrence of gastro-oesophageal reflux (GOR) following redo Nissen fundoplication represents a significant clinical problem. The aim of this study was to identify factors predicting failure of redo Nissen fundoplication. The notes of children who underwent redo Nissen fundoplication for recurrent GOR in a single institution between June 1994 and May 2005 were reviewed. Data are reported as median (range), or as numbers of cases. Multiple logistic regression analysis, using type of first fundoplication, neurological status, presence of gastrostomy, age-weight, retching-gas bloat after first fundoplication, associated anomalies, oesophageal atresia and length of follow-up as factors, was used to generate a model to identify factors predicting recurrent vomiting (failure) after redo. Eighty-one children underwent redo Nissen fundoplication 15.9 months (0.2-176) after the initial Nissen fundoplication. In 29, the first Nissen was laparoscopic. Age at redo Nissen fundoplication was 3.3 years (0.3-15.9) and weight 12.8 kg (5-60). Thirty-four children (42%) presented with recurrent vomiting (failure). Overall, the model successfully predicted vomiting (failure) after redo fundoplication (P = 0.009). Open surgery at first fundoplication (P = 0.011) and neurological impairment (P = 0.046) were both significant predictors of redo failure in the model, whereas presence of gastrostomy (P = 0.035) and older-heavier age-weight (P = 0.028) were associated with significantly better results. Retching-gas bloat, associated anomalies and oesophageal atresia were not significant predictors of failure. Redo Nissen fundoplication has a high failure rate. Risk factors are open fundoplication at first operation and neurological impairment. Redo fundoplication after primary laparoscopic Nissen has a lower risk of failure.

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Section: Discussionmentioning

confidence: 99%

Factors predicting failure of redo Nissen fundoplication in children

et al. 2007

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“…GER development has been speculated to he due to tension on the distal esophagus as a result of the anastomosis, which reduces the acuity of the angle of His. As division of the TEF and end-to-end esophageal anastomosis is considered to be the ideal method for neonates with EA-TEF, GER is expected to develop in 20-30% of such patients7, 10,14,15).…”

Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux after Repair of Esophageal Atresia and Tracheoesophageal Fistula.

Ohhama

1997

kmj

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“…Typically, in most EA patients who have undergone anti-reflux surgery the symptoms are initially alleviated (17, 32, 33). Unfortunately, the positive effect of fundoplication is transient in a significant proportion of patients.…”

Section: Outcomes Of Fundoplication In Eamentioning

confidence: 99%

“…The wrap failure rates range between 20 and 45% (17, 32–35). This is significantly higher rate than in those who undergo fundoplication without any underlying anatomic defect (33).…”

Section: Outcomes Of Fundoplication In Eamentioning

confidence: 99%

Fundoplication in Patients with Esophageal Atresia: Patient Selection, Indications, and Outcomes

Rintala

2017

Front. Pediatr.

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Patients with esophageal atresia (EA) suffer from abnormal and permanent esophageal intrinsic and extrinsic innervation that affects severely esophageal motility. The repair of EA also results in esophageal shortening that affects distal esophageal sphincter mechanism. Consequently, gastroesophageal reflux (GER) is common in these patients, overall approximately half of them suffer from symptomatic reflux. GER in EA patients often resists medical therapy and anti-reflux surgery in the form of fundoplication is required. In patients with pure and long gap EA, the barrier mechanisms against reflux are even more damaged, therefore, most of these patients undergo fundoplication during first year of life. Other indications for anti-reflux surgery include recalcitrant anastomotic stenoses and apparent life-threatening episodes. In short term, fundoplication alleviates symptoms in most patients but recurrences are common occurring in at least one third of the patients. Patients with fundoplication wrap failure often require redo surgery, which may be complicated and associated with significant morbidity. A safe option in a subset of patients with failed anti-reflux surgery appears to be long-term medical treatment with proton pump inhibitors.

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Nissen Fundoplication for Gastro-Esophageal Reflux in Repaired Tracheo-Esophageal Fistula

Cited by 16 publications

References 1 publication

Factors predicting failure of redo Nissen fundoplication in children

Factors predicting failure of redo Nissen fundoplication in children

Gastroesophageal Reflux after Repair of Esophageal Atresia and Tracheoesophageal Fistula.

Fundoplication in Patients with Esophageal Atresia: Patient Selection, Indications, and Outcomes

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