Wei Ru1, Peng Wu2, Shaoguang Feng3, Xin-He Lai4, Guorong Chen5. 1. Department of Urology and Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. 2. Department of Pediatric Surgery, Northwest Women and Children's Hospital (Shaanxi Provincial Maternity Hospital), Xi'an, Shaanxi, China. 3. Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, China. 4. Institute of Inflammation and Diseases, Institute of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 5. Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: jackiefung@163.com.
Abstract
PURPOSE: To systematically review and meta-analyze studies that have compared the clinical outcomes of laparoscopic and open Nissen fundoplication on children. METHODS: Online databases were searched to identify studies that have compared the laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) on children, looking specifically for operative time, time to full feed, redo fundoplication rates and total postoperative complications including wound infection, retching, and airway complications. RESULTS: Of those 916 patients in the 9 selected studies, 557 and 359 patients had undergone LNF and ONF, respectively; and LNF had significant longer operative time and less total postoperative complications including retching and airway complications than ONF. However, no significant difference in time to full feed, wound infection, and redo fundoplication rates was found between LNF and ONF in children. CONCLUSION: LNF is a safe, feasible, and effective surgical procedure alternative to ONF for gastroesophageal reflux in children. Compared with ONF, LNF has the advantage of less total postoperative complications including retching and airway complications. In addition, LNF is comparable to ONF in terms of time to full feed, wound infection, and redo fundoplication rates. Therefore, we conclude that LNF should be regarded as an acceptable option for children.
PURPOSE: To systematically review and meta-analyze studies that have compared the clinical outcomes of laparoscopic and open Nissen fundoplication on children. METHODS: Online databases were searched to identify studies that have compared the laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) on children, looking specifically for operative time, time to full feed, redo fundoplication rates and total postoperative complications including wound infection, retching, and airway complications. RESULTS: Of those 916 patients in the 9 selected studies, 557 and 359 patients had undergone LNF and ONF, respectively; and LNF had significant longer operative time and less total postoperative complications including retching and airway complications than ONF. However, no significant difference in time to full feed, wound infection, and redo fundoplication rates was found between LNF and ONF in children. CONCLUSION: LNF is a safe, feasible, and effective surgical procedure alternative to ONF for gastroesophageal reflux in children. Compared with ONF, LNF has the advantage of less total postoperative complications including retching and airway complications. In addition, LNF is comparable to ONF in terms of time to full feed, wound infection, and redo fundoplication rates. Therefore, we conclude that LNF should be regarded as an acceptable option for children.
Authors: Sara Maria Cravano; Marco Di Mitri; Giovanni Parente; Eduje Thomas; Chiara Girella; Simone D'Antonio; Tommaso Gargano; Mario Lima Journal: Updates Surg Date: 2022-09-21