Operation for gastro-oesophageal reflux associated with severe mental retardation.

Abstract

One hundred and seventy six children with severe mental retardation underwent a fundoplication for considerable gastro-oesophageal reflux. There were six 'early' (3%) deaths and five 'late' deaths. Major complications developed in 17 (10%) children whereas 86 (49%) had 'minor' complications. A revision operation was required in 27 patients. Overali 142 (81%) children achieved a good result.In spite of the high complication rate and the need for a secondary operation in 15% of the patients, the quality of life for these children and their parents and carers is greatly improved by antireflux surgery.

Laparoscopic surgery in children

“…Recurrent herniation occurred in 7 (3.2%) children, which is exceptional compared even to some series of open fundoplications. 40 Table 2 illustrates recent experience with LN.…”

Children with neurological disorders do not always need fundoplication concomitant with percutaneous endoscopic gastrostomy

“…Jolley et al (1985) consider that gastrostomy in this group should be coupled with a prophylactic fundoplication. However, such major surgery is associated with significant morbidity and mortality, particularly in the child with neurological disabilities, in whom recurrence of GOR is also more common (Martinez et al 1992, Spitz et al 1993). This study aims to examine outcome in a group of children with neurological impairments without clinical evidence of severe GOR, who underwent PEG insertion without concomitant antireflux surgery.…”

Serebral Palsi̇li̇ Çocuklarda Beslenme Problemleri̇ Ve Tedavi̇si̇

“…Nörolojik problemi olan çocuklarda, fundo-plikasyon %20 olguda reflüyü engelleyememektedir, %0.9-3 arasında görülen operatif mortalite, %26-59 arasında görülen postoperatif komplikasyon oranları gerek ebeveynlerin gerek hekimlerin gözünü korkutmaktadır (19,20). Bu nedenle endikasyonlar iyi belirlenmelidir.…”