Predictors of anti-reflux procedure failure in complex esophageal atresia patients

Thompson, Kyle; Zendejas, Benjamin; Kamran, Ali; Svetanoff, Wendy Jo; Meisner, Jay; Zurakowski, David; Staffa, Steven J.; Ngo, Peter; Manfredi, Michael A.; Yasuda, Jessica L.; Jennings, Russell W.; Smithers, C. Jason; Hamilton, Thomas E.

doi:10.1016/j.jpedsurg.2021.08.005

Cited by 3 publications

(1 citation statement)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 9–11 Complications include worsening of preexistent dysphagia, new-onset dysphagia, bloating, gagging/retching and feeding difficulties. 7 , 12 Fundoplication can also increase esophageal stasis, resulting in an increased direct aspiration risk, worsening of respiratory symptoms and/or brief resolved unexplained events (BRUEs). 13 In addition, dumping syndrome can occur in patients post-fundoplication.…”

Section: Introductionmentioning

confidence: 99%

Fundoplication in children with esophageal atresia: preoperative workup and outcome

Lennep

Chung

Jiwane

et al. 2022

Diseases of the Esophagus

View full text Add to dashboard Cite

Summary Up to 45% of esophageal atresia (EA) patients undergo fundoplication during childhood. Their esophageal dysmotility may predispose to worse fundoplication outcomes compared with patients without EA. We therefore compared fundoplication outcomes and symptoms pre- and post-fundoplication in EA patients with matched patients without EA. A retrospective review of patients with- and without EA who underwent a fundoplication was performed between 2006 and 2017. Therapeutic success was defined as complete sustained resolution of symptoms that were the reason to perform fundoplication. Fundoplication indications of 39 EA patients (49% male; median age 1.1 [0.1–17.0] yrs) and 39 non-EA patients (46% male; median age 1.3 [0.3–17.0] yrs) included respiratory symptoms, brief resolved unexplained events, typical symptoms of gastroesophageal reflux disease, recurrent strictures and respiratory problems. Post-fundoplication, therapeutic success was achieved in 5 (13%) EA patients versus 29 (74%) non-EA patients (P<0.001). Despite therapeutic success, all 5 (13%) EA patients developed postoperative sustained symptoms/complications versus 12 (31%) non-EA patients. Eleven (28%) EA patients versus 3 (8%) non-EA patients did not achieve any therapeutic success (P=0.036). Remaining patients achieved partial therapeutic success. EA patients suffered significantly more often from postoperative sustained dysphagia (41% vs. 13%; P=0.039), gagging (33% vs. 23%; P<0.001) and bloating (40% vs. 17%; P=0.022). Fundoplication outcomes in EA patients are poor and EA patients are more susceptible to post-fundoplication sustained symptoms and complications compared with patients without EA. The decision to perform fundoplication in EA patients with proven gastroesophageal reflux disease needs to be made with caution after thorough multidisciplinary evaluation.

show abstract