Two-Year Outcome after Laparoscopic Fundoplication in Pediatric Patients with Gastroesophageal Reflux Disease

Stellato, Rebecca K.; Mulder, Femke V M; Tytgat, Stefaan H.A.J.; Oudman, Tycho S; Zee, David C. van der; Peppel-Mauritz, Femke A van de; Lindeboom, Maud Y. A.

doi:10.1089/lap.2020.0014

Cited by 5 publications

(3 citation statements)

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“…An FP for GERD is reported to be successful in more than 85% of the children in terms of complete relief of the symptoms (1); however, decline in symptom-free patients declined over time was described (5,6). Therefore, a long-term follow-up evaluation is fundamental to determine whether complications develop afterward and reduce the satisfactory outcome that was initially observed.…”

Section: Discussionmentioning

confidence: 99%

Anti-reflux surgery for gastroesophageal reflux in neurological impaired and non-impaired children: Long term outcomes after a median follow-up of more than 10 years

et al. 2020

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Introduction: The durability of a fundoplication (FP) in the treatment of gastroesophageal reflux disease (GERD) in children must be confirmed in the long-term. This study aimed to present the long-term outcome after a minimum of five years. Methods: Perioperative data were retrospectively reviewed from clinical records, and the follow-up data were collected through a standardized questionnaire. In total, 21 neurologically impaired (NI) and nine neurologically non-impaired (NNI) children were included in this study. The statistical analysis was performed using SPSS software (version 25) through Fisher’s exact test, t-test, and Kaplan-Meier analysis. A p-value of less than 0.05 was considered statistically significant. Results: The median follow-up period was 10.8 years (5-19.7), and the refundoplication rates ranged from 11% to 19%. Revisions were usually necessary within the first two postoperative years. Most delayed refundoplications were necessary for the NI children with a laparoscopic Nissen FP. In the long-term, symptoms and medication administration program were favorable in most cases. Most parents were highly satisfied with the postoperative outcome and would approve that FP is conducted on their child again under the same circumstances. Conclusions: The FP is a safe procedure with consistent benefits in the first 10 postoperative years in NI and NNI children with documented GERD. The NI children treated with a laparoscopic Nissen FP necessitate longer postoperative surveillance since more delayed redofundoplications were required in this group.

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Section: Discussionmentioning

confidence: 99%

Anti-reflux surgery for gastroesophageal reflux in neurological impaired and non-impaired children: Long term outcomes after a median follow-up of more than 10 years

et al. 2020

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“…As reported previously, HRQOL increased significantly in this cohort 3 months after LARS but decreased after 2 years, though not significantly. 14,21 The 5-year PedQL total score is higher, though not significantly, than preoperative levels (mean difference 4.8, 95% CI (− 2.5; 12.0)) and lower (also not significantly) than 3-month postoperative levels (mean difference − 4.3, 95% CI (− 11.6; 2.9)).…”

Section: Hrqolmentioning

confidence: 93%

“…The short-term follow-up (3-4 months) and intermediate term follow-up (1-2 years) after ARS have been described in previous papers. 4,21 Reflux Symptom Questionnaire…”

Section: Clinical Assessmentmentioning

confidence: 99%

Five-Year Outcome of Laparoscopic Fundoplication in Pediatric GERD Patients: a Multicenter, Prospective Cohort Study

Stellato

Colmer

Tytgat

et al. 2021

Journal of Gastrointestinal Surgery

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Background Gastroesophageal reflux disease (GERD) is a common disease in children. When drug treatment fails, laparoscopic anti-reflux surgery (LARS) is considered. Short-term follow-up studies report high success rates; however, few studies report long-term results. The aim of this study was to describe the long-term effects of LARS in pediatric patients. Methods A prospective, multicenter study of 25 laparoscopic fundoplication patients was performed. At 3 months and 1, 2, and 5 years postoperatively, patients and caregivers were asked to complete the gastroesophageal reflux symptom questionnaire to assess symptoms and the PedsQL™ to assess health-related quality of life (HRQoL). Results Reflux symptom severity was still significantly improved 5 years after LARS compared with preoperative levels (p < 0.0001). However, 26% of patients reported moderate or severe reflux symptoms. Dysphagia was reported in 13% of patients 5 years after LARS and was more common in children with neurologic impairment and children who underwent a Nissen procedure. The increase in HRQoL 3 months postoperatively appears to decline over time: 5 years after surgery, HRQoL was lower, though not significantly, than 3 months postoperatively. HRQoL at 5 years was still higher, though also not significantly, than preoperative levels. The presence of reflux symptoms after surgery was not significantly associated with lower HRQoL. Conclusions LARS is effective for therapy-resistant GERD in children. Five years after surgery, reflux symptoms are still improved. However, we observed a decline in symptom-free patients over time. The initial increase in HRQoL shortly after LARS appears to decline over time. Trial Registration Dutch national trial registry Identifier: 2934 (www.trialregister.nl)

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Surgical Options to Treat GERD

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2022

Gastroesophageal Reflux in Children

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Two-Year Outcome after Laparoscopic Fundoplication in Pediatric Patients with Gastroesophageal Reflux Disease

Cited by 5 publications

References 32 publications

Anti-reflux surgery for gastroesophageal reflux in neurological impaired and non-impaired children: Long term outcomes after a median follow-up of more than 10 years

Anti-reflux surgery for gastroesophageal reflux in neurological impaired and non-impaired children: Long term outcomes after a median follow-up of more than 10 years

Five-Year Outcome of Laparoscopic Fundoplication in Pediatric GERD Patients: a Multicenter, Prospective Cohort Study

Surgical Options to Treat GERD

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