scholarly journals Is There a Role for Elective Early Upper Gastrointestinal Contrast Study in Neurologically Impaired Children following Laparoscopic Nissen Fundoplication?

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 813
Author(s):  
Thomas M. Benkoe ◽  
Katrin Rezkalla ◽  
Lukas Wisgrill ◽  
Martin L. Metzelder
Keyword(s):  
Postoperative Complications ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Contrast Study ◽  
Neurologically Impaired ◽  
Early Postoperative Complications ◽  
Laparoscopic Nissen ◽  
Upper Gastrointestinal ◽  
Contrast Studies

Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear. We aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention.

Ten-Year Follow up after Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease

2007 ◽  
Vol 73 (8) ◽  
pp. 748-753 ◽  
Author(s):  
Sarah M. Cowgill ◽  
Rachel Gillman ◽  
Emily Kraemer ◽  
Sam Al-Saadi ◽  
Desiree Villadolid ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Gastroesophageal Reflux Disease ◽  
Reflux Disease ◽  
Laparoscopic Fundoplication ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Initial Experience ◽  
Laparoscopic Nissen

Laparoscopic Nissen fundoplication was first undertaken in the early 1990s. Appreciable numbers of patients with 10-year follow up are only now available. This study assesses long-term outcome and durability of outcome after laparoscopic Nissen fundoplication for treatment of gastro-esophageal reflux disease. Since 1991, 829 patients have undergone laparoscopic fundoplications and are prospectively followed. Two hundred thirty-nine patients, 44 per cent male, with a median age of 53 years (± 15 standard deviation) underwent laparoscopic Nissen fundoplications at least 10 years ago; 28 (12%) patients were “redo” fundoplications. Before and after fundoplication, among many symptoms, patients scored the frequency and severity of dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Symptom scores before versus after fundoplication were compared using a Wilcoxon matched-pairs test. Data are reported as median, mean ± standard deviation, when appropriate. After fundoplication, length of stay was 2 days, 3 days ± 4.8. Intra-operative inadvertent events were uncommon and without sequela: 1 esophagotomy, 1 gastrotomy, 3 cardiac dysrhythmias, and 3 CO2 pneumothoraces. Complications after fundoplication included: 1 postpneumonic empyema, 3 urinary retentions, 2 superficial wound infections, 1 urinary tract infection, 1 ileus, and 1 intraabdominal abscess. There were two perioperative deaths; 88 per cent of the patients are still alive. After laparoscopic Nissen fundoplication, frequency and severity scores dramatically improved for all symptoms queried (P < 0.001), especially for heartburn frequency (8, 8 ± 3.2 versus 2, 3 ± 2.8, P < 0.001) and severity (10, 8 ± 2.9 versus 1, 2 ± 2.5, P < 0.001). Eighty per cent of patients rate their symptoms as almost completely resolved or greatly improved, and 85 per cent note they would again have the laparoscopic fundoplication as a result of analysis of our initial experience, thereby promoting superior outcomes in the future. Nonetheless, follow up at 10 years and beyond of our initial experience documents that laparoscopic fundoplication durably provides high patient satisfaction resulting from long-term amelioration of the frequency and severity of symptoms of gastroesophageal reflux disease. These results promote further application of laparoscopic Nissen fundoplication.

Laparoscopic Nissen fundoplication in children: 2?5-year follow-up

2003 ◽  
Vol 19 (7) ◽  
pp. 537-539 ◽  
Author(s):  
M. C. Bourne ◽  
C. Wheeldon ◽  
G. A. MacKinlay ◽  
F. D. Munro
Keyword(s):  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Laparoscopic Nissen

Laparoscopic Nissen Fundoplication for GERD

2017 ◽  
Author(s):  
Rachel J. Kwon
Keyword(s):  
Minimally Invasive Surgery ◽  
Clinical Case ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Open Surgical Procedure ◽  
Laparoscopic Nissen ◽  
Study Intervention ◽  
Reoperation Rates ◽  
Landmark Study

This chapter provides a summary of a landmark study in minimally invasive surgery. How does laparoscopic Nissen fundoplication compare to an open surgical procedure in patients with gastroesophageal reflux disease with respect to reflux symptoms and reoperation rates? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case on laparoscopic Nissen fundoplication.

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