Laparoscopic vs open fundoplication in infants

Somme, S, Rodriguez, JA, Kirsch, DG and Liu, DC (2002) Laparoscopic vs open fundoplication in infants. Surgical Endoscopy and Other Interventional Techniques, 16 1: 54-56. doi:10.1007/s00464-001-8147-1


Author Somme, S
Rodriguez, JA
Kirsch, DG
Liu, DC
Title Laparoscopic vs open fundoplication in infants
Journal name Surgical Endoscopy and Other Interventional Techniques   Check publisher's open access policy
ISSN 0930-2794
Publication date 2002-01
Sub-type Article (original research)
DOI 10.1007/s00464-001-8147-1
Volume 16
Issue 1
Start page 54
End page 56
Total pages 3
Language eng
Formatted abstract
Background: Laparoscopic esophagogastric fundoplication is an effective treatment for severe gastroesophageal reflux disease (GERD), although its role in the very young is still largely undetermined. We review our surgical outcome in infants with severe GERD, comparing laparoscopic (LNF) with open (ONF) Nissen fundoplication.

Methods: This study reviewed 55 consecutive Nissen fundoplications performed for GERD on infants less than 1 year old at our institution between January 1996 and June 2000. The follow-up period for LNF averaged 14.2 months (range, 3.3-42 months), as compared with 16.5 months (range, 1-37.1 months) for ONF (p was not significant, t-test). Surgical outcome was compared in terms of the following parameters: average operative time, times to initiation and completion of feeding schedule, postoperative complications, and recurrence rates.

Results: For the study, 53 infants were divided into two groups: LNF (n = 39; 73.6%) and ONF (n = 14; 26.4%). The average operating time for LNF was 120 ± 24 min (range, 60-195 min), as compared with 91 ± 21 min (range, 60-135 min) for ONF (p < 0.05, t-test). Time to initiation of postoperative feeding schedule was 1.3 ± 0.3 days for LNF, as compared with 3 ± 0.9 days for ONF (p < 0.05, t-test). Full feedings were reached in 1.7 ± 0.6 days for LNF, as compared with 1.3 ± 0.9 for ONF (p was not significant, t-test). During the short-term follow-up period, recurrent reflux developed in 2/14 ONF patients (14.3%) as compared with 1/39 LNF patients (2.6%) (p < 0.05).

Conclusions:
We conclude that in addition to sparing infants the morbidity of celiotomy, laparoscopic Nissen fundoplication had a surgical outcome comparable to that of traditional open fundoplication in infants with severe GERD. Importantly, resumption of goal nutritional regimens was equally efficient in both groups.
Keyword Infants
Laparoscopic fundoplication
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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