Problems Associated With a Nissen Fundoplication Following Tracheoesophageal Fistula and Esophageal Atresia Repair

Curci, Michael R.; Dibbins, Albert W.

doi:10.1001/archsurg.1988.01400290104018

Cited by 53 publications

(24 citation statements)

References 21 publications

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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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“…Gastroesophageal reflux is frequently associated with EA or tracheoesophageal fistula repair [7] and may result in anastomotic stenosis and recurrent pulmonary infections [8]. Tracheomalacia may be present and increases the risk of respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

Reflux in esophageal atresia, tracheoesophageal cleft, and esophagocoloplasty: Bianchi's procedure as an alternative approach

Lagausie

Bonnard

Schultz

et al. 2005

Journal of Pediatric Surgery

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“…However, in recent years, pediatric surgeons and others have documented high rates of failure and morbidity of antireflux surgery and occasional death. [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] Some of these data are summarized elsewhere. 70 The problems with antireflux surgery occur especially in children with neurologic impairment (NI), repaired esophageal atresia, or chronic lung disease and to a lesser degree in otherwise normal children.…”

Section: Antireflux Surgerymentioning

confidence: 99%

“…[69][70][71] In children with repaired esophageal atresia, only 40% had an excellent result at 5 years, including those requiring reoperation. 67,68 Martinez et al 65 found that recognition of recurrent GER after antireflux surgery required a high index of suspicion, repeated testing over time, and use of more than one test; whereas barium study is useful for identifying a slipped wrap or stricture, intraesophageal pH and endoscopy are required to diagnose acid reflux and esophagitis, respectively.…”

Section: Antireflux Surgerymentioning

confidence: 99%