Morten Kvello1, Charlotte K Knatten2, Thomas J Fyhn3, Kristin Bjørnland3. 1. Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Norway. Electronic address: m.kvello@gmail.com. 2. Department of Pediatrics, Oslo University Hospital, Norway. 3. Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Norway.
Abstract
BACKGROUND: Redo fundoplication (RF) is the most common surgical treatment for recurrent gastroesophageal reflux disease (GERD) in children, but outcomes after RF are rarely reported. The aim of this study was to assess short- and long-term outcomes after RF in childhood. METHODS: The study is a follow-up study of patients undergoing RF from 2002 to 2020 at a teriary care center. Patients/parents were sent questionnaires recording symptoms of recurrent GERD, troublesome side-effects and satisfaction. Retrospective chart review was also performed. RESULTS: 24/28 (86%) patients were included median 9 (1.6 months-17.7 years) years after RF. 16 (67%) had neurologic impairment. Indications for RF was recurrence of GERD (n = 18), discomfort or dysphagia from a herniated wrap (n = 5) and dysphagia from a slipped fundoplication (n = 1). Median operating time was 128 (95-250) min. Six (25%) patients experienced early major complications, of which two were gastrostomy related. Five (21%) patients experienced recurrence after RF. Three of these were symptom free at follow-up with medical treatment or re-RF. The most common symptom at follow-up was stomach pain (37%) and excessive flatulence (38%). 18/22 (95%) patients/parents would choose RF again, and 21/22 would recommend RF to someone in a similar situation. CONCLUSIONS: RF is successful in treating recurrent GERD after primary fundoplication, and patient/parental satisfaction is high.
BACKGROUND: Redo fundoplication (RF) is the most common surgical treatment for recurrent gastroesophageal reflux disease (GERD) in children, but outcomes after RF are rarely reported. The aim of this study was to assess short- and long-term outcomes after RF in childhood. METHODS: The study is a follow-up study of patients undergoing RF from 2002 to 2020 at a teriary care center. Patients/parents were sent questionnaires recording symptoms of recurrent GERD, troublesome side-effects and satisfaction. Retrospective chart review was also performed. RESULTS: 24/28 (86%) patients were included median 9 (1.6 months-17.7 years) years after RF. 16 (67%) had neurologic impairment. Indications for RF was recurrence of GERD (n = 18), discomfort or dysphagia from a herniated wrap (n = 5) and dysphagia from a slipped fundoplication (n = 1). Median operating time was 128 (95-250) min. Six (25%) patients experienced early major complications, of which two were gastrostomy related. Five (21%) patients experienced recurrence after RF. Three of these were symptom free at follow-up with medical treatment or re-RF. The most common symptom at follow-up was stomach pain (37%) and excessive flatulence (38%). 18/22 (95%) patients/parents would choose RF again, and 21/22 would recommend RF to someone in a similar situation. CONCLUSIONS: RF is successful in treating recurrent GERD after primary fundoplication, and patient/parental satisfaction is high.
Authors: Debasish B Banerjee; Pooja Parekh; Kate Cross; Simon Blackburn; Derek J Roebuck; Joe Curry; Simon Eaton; Premal A Patel; Paolo De Coppi Journal: Pediatr Surg Int Date: 2022-02-26 Impact factor: 1.827