Nissen Fundoplication

Madiwale, Manasi Vivek; Sahai, Shashi

doi:10.1177/0009922814540205

Cited by 6 publications

(2 citation statements)

References 36 publications

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“…Madiwale et al found out that fundoplication in children was associated with a higher incidence of complications, which supported the slightly higher percentage of complications in HMF patients. 36 In addition, it was found that the most common complication in both groups in our study were intraoperative mucosal perforation (IMP) during myotomy. It is important to take into account that HMF children had more preoperative surgical and/or pharmacological interventions, which might have impacted the condition of the patients and made them prone to developing complications.…”

Section: Discussionmentioning

confidence: 59%

Fundoplication in Pediatric Achalasia Patients Undergoing Heller’s Myotomy: A Systematic Review

Susanto,

O’Connor,

Teague

2023

Arch Pediatr Gastr Hepatol Nutr

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Background: Achalasia is a rare motility disorder, with the incidence being the lowest among children. The disease is caused by the inability of the LOS to relax and the absence of normal peristalsis of esophagus. Heller’s myotomy has been known to be the gold standard management of achalasia, however, reports on postoperative GERD were established in the past. To control the reflux symptoms, fundoplication has been used as an addition to Heller’s myotomy. Unfortunately, there has been an inconclusive finding from available studies regarding the need for performing fundoplication. Hence, we aim to determine whether or not the addition of fundoplication to Heller myotomy in achalasia children resulted in better postoperative outcomes and fewer complications of GERD. Methods: A literature search was carried out in four databases: Medline, EMBASE, Pubmed, and Cochrane Library. The search was limited to publications from 2006 to 2019, English studies, and achalasia patients age 0-18 years old that underwent Heller’s myotomy. The exclusion of studies from the primary screening according to title and abstracts and secondary screening on the full text were done according to a priori protocol. Duplicate studies were also eliminated by using reference management software and manually. Results: A total of 446 studies were retrieved from the search. Preliminary screening based on the eligibility criteria resulted in 21 articles to be included in this review. A total of 410 patients were included in this study, in which 80 underwent HM alone and 330 experienced fundoplication as an adjunct to HM (HMF). There was a higher proportion of asymptomatic patients in the HM group (56.3%) compared to HMF (48.8%). Both groups had a similar rate of complications (HMF 12.1%, HM 10.0%). However, in terms of postoperative GERD, slightly better results were seen among HMF patients (9.7%) than HM (15%). Conclusion: Fundoplication did not result in better resolution of symptoms, as seen from its percentage of asymptomatic patients. Improvements in postoperative GERD were seen in HMF patients, however, it was deemed as insignificant. The findings suggest that there was a limited benefit in using fundoplication.

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Section: Discussionmentioning

confidence: 59%

Fundoplication in Pediatric Achalasia Patients Undergoing Heller’s Myotomy: A Systematic Review

Susanto,

O’Connor,

Teague

2023

Arch Pediatr Gastr Hepatol Nutr

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“…Dysphagia in patients following a fundoplication can be caused by a tight, slipped, or herniated wrap or wrap breakdown (15). A contrast study is often helpful in delineating the anatomy of the fundoplication and helps direct treatment.…”

Section: Esophageal Motor Disorder: Diagnosis and Management Of Achal...mentioning

confidence: 99%

Proceedings of the 2018 Advances In Motility and In NeuroGastroenterology

Ambartsumyan

Khlevner

Nurko

et al. 2020

J. pediatr. gastroenterol. nutr.

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Objectives:Motility and functional disorders are common in children and often debilitating, yet these disorders remain challenging to treat effectively. At the 2018 Annual North American Society for Pediatric Gastroenterology, Hepatology and Nutrition meeting, the Neurogastroenterology and Motility Committee held a full day symposium entitled, 2018 Advances In Motility and In NeuroGastroenterology – AIMING for the future. The symposium aimed to explore clinical paradigms in pediatric gastrointestinal motility disorders and provided a foundation for advancing new scientific and therapeutic research strategies.Methods:The symposium brought together leading experts throughout North America to review the state of the art in the diagnosis and management of motility and functional disorders in children. Presentations were divided into esophageal, antral duodenal, and colorectal modules. Each module included oral presentations by experts in the respective fields, leading to thought-provoking discussions. There were 2 breakout sessions with small group discussions on select topics, focusing on defining scientific insights into the diagnosis and management of pediatric functional gastrointestinal and motility disorders in a systematic, segment-based approach.Conclusions:The field of neurogastroenterology has made remarkable progress in the last decade. The current report summarizes the major learning points from the symposium highlighting the diagnosis and promising therapies on the horizon for pediatric neurogastrointestinal and motility disorders.

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Chronic Cough and Gastroesophageal Reflux in Children

Panel

2019

Chest

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BACKGROUND: Whether gastroesophageal reflux (GER) or GER disease (GERD) causes chronic cough in children is controversial. Using the Population, Intervention, Comparison, Outcome (PICO) format, we undertook four systematic reviews. For children with chronic cough (> 4-weeks duration) and without underlying lung disease: (1) who do not have gastrointestinal GER symptoms, should empirical treatment for GERD be used? (2) with gastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with or without gastrointestinal GER symptoms, what GER-based therapies should be used and for how long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteria best determine GERD as the cause of the cough? METHODS: We used the CHEST Expert Cough Panel's protocol and American College of Chest Physicians (CHEST) methodological guidelines and GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Delphi methodology was used to obtain consensus. RESULTS: Few randomized controlled trials addressed the first two questions and none addressed the other two. The single meta-analysis (two randomized controlled trials) showed no significant difference between the groups (any intervention for GERD vs placebo for cough resolution; OR, 1.14; 95% CI, 0.45-2.93; P ¼ .78). Proton pump inhibitors (vs placebo) caused increased serious adverse events. Qualitative data from existing CHEST cough systematic reviews were consistent with two international GERD guidelines. CONCLUSIONS: The panelists endorsed that: (1) treatment(s) for GERD should not be used when there are no clinical features of GERD; and (2) pediatric GERD guidelines should be used to guide treatment and investigations.

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Nissen Fundoplication

Cited by 6 publications

References 36 publications

Fundoplication in Pediatric Achalasia Patients Undergoing Heller’s Myotomy: A Systematic Review

Fundoplication in Pediatric Achalasia Patients Undergoing Heller’s Myotomy: A Systematic Review

Proceedings of the 2018 Advances In Motility and In NeuroGastroenterology

Chronic Cough and Gastroesophageal Reflux in Children

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