Samantha A Pellegrino1, Sebastian K King2, Elizabeth McLeod3, Alisa Hawley4, Jo-Anne Brooks4, John M Hutson5, Warwick J Teague6. 1. Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia. 2. Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Australia. 3. Department of Pediatric Surgery, The Royal Children's Hospital, Melbourne, Australia. 4. Department of Pediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Neonatal Research Group, Murdoch Children's Research Institute, Melbourne, Australia. 5. Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Department of Urology, The Royal Children's Hospital, Melbourne, Australia. 6. Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia. Electronic address: warwick.teague@rch.org.au.
Abstract
OBJECTIVES: Fundoplication is commonly performed in patients with a history of esophageal atresia (EA), however, the success of this surgery is reduced, as reflected by an increased rate of redo fundoplication. We aimed to determine whether EA impacts the prevalence of fundoplication, its timing, and performance of a redo operation. STUDY DESIGN: A single-center, retrospective review of all patients undergoing fundoplication over a 20-year period (1994-2013) was performed. Redo fundoplication was used as a surrogate for surgical failure. RESULTS: A total of 767 patients (patients with EA 85, those who did not have EA 682) underwent fundoplication during the study period. Median age (months) at primary fundoplication was lower in patients with EA (7.2 vs those who did not have EA 23.3; P < .001). Redo fundoplication rates between groups were not significantly different (EA 11/85 vs 53/682; P = .14). Median time (months) between primary and redo fundoplication was greater in patients with EA (36.2 vs 11.7; P = .03). CONCLUSIONS: Contrary to popular belief, the incidence of redo fundoplication was not significantly increased in patients with a history of EA. However, patients with EA underwent fundoplication at younger ages, which may be related to early life-threatening events in these patients. These results inform perioperative counseling, and highlight the importance of sustained surgical follow-up in patients with EA.
OBJECTIVES: Fundoplication is commonly performed in patients with a history of esophageal atresia (EA), however, the success of this surgery is reduced, as reflected by an increased rate of redo fundoplication. We aimed to determine whether EA impacts the prevalence of fundoplication, its timing, and performance of a redo operation. STUDY DESIGN: A single-center, retrospective review of all patients undergoing fundoplication over a 20-year period (1994-2013) was performed. Redo fundoplication was used as a surrogate for surgical failure. RESULTS: A total of 767 patients (patients with EA 85, those who did not have EA 682) underwent fundoplication during the study period. Median age (months) at primary fundoplication was lower in patients with EA (7.2 vs those who did not have EA 23.3; P < .001). Redo fundoplication rates between groups were not significantly different (EA 11/85 vs 53/682; P = .14). Median time (months) between primary and redo fundoplication was greater in patients with EA (36.2 vs 11.7; P = .03). CONCLUSIONS: Contrary to popular belief, the incidence of redo fundoplication was not significantly increased in patients with a history of EA. However, patients with EA underwent fundoplication at younger ages, which may be related to early life-threatening events in these patients. These results inform perioperative counseling, and highlight the importance of sustained surgical follow-up in patients with EA.
Authors: Marinde van Lennep; Eric Chung; Ashish Jiwane; Rajendra Saoji; Ramon R Gorter; Marc A Benninga; Usha Krishnan; Michiel P van Wijk Journal: Dis Esophagus Date: 2022-10-14 Impact factor: 2.822