Laparoscopic surgery for gastroesophageal reflux disease during the first year of life
Details
Serval ID
serval:BIB_E1E5D2BB0B00
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Laparoscopic surgery for gastroesophageal reflux disease during the first year of life
Journal
Journal of Pediatric Surgery
ISSN
0022-3468 (Print)
Publication state
Published
Issued date
05/2001
Volume
36
Number
5
Pages
715-7
Notes
Journal Article --- Old month value: May
Abstract
BACKGROUND: Very few children need gastroesophageal antireflux surgery during their first year of life; hence, no series has been published so far. The authors report their experience in 3 centers. METHODS: From January 1993 to December 1998, 36 infants between 23 days and 13 months of age, suffering from gastroesophageal reflux disease (GERD), underwent surgery by a laparoscopic approach. The patients' weights ranged from 2.4 to 8.5 kg. Preoperative diagnostic studies included esophagograms, manometries, endoscopies, and pH-metries. Fifteen babies (41.6%) had associated anomalies, and 10 (27.7%) were neurologically impaired. Thirty-six laparoscopic fundoplications were performed according to either Toupet's procedure (17 of 36), Rossetti's (10 of 36), Nissen's (8 of 36) or Lortat-Jacob's (1 of 36). Four infants previously had undergone a gastrostomy, whereas 6 needed one during the antireflux procedure. RESULTS: There was no mortality in our series. Three infants (8.3%) had an intraoperative complication: 1 lesion of a diaphragmatic vessel, 1 pneumothorax, and 1 case of severe hiatal hernia requiring conversion to open surgery. During the median follow-up of 22 months, 4 redo procedures were performed (11.1%). CONCLUSIONS: This experience shows the feasibility of laparoscopic fundoplication even in children below 1 year of age. An accurate preoperative diagnostic study is mandatory, because 50% of these patients presented associated anomalies. A long and accurate follow-up is necessary to evaluate long-term results and detect possible complications, which can occur as late as 1 year after surgery. In addition, we believe that redo antireflux surgery is possible by the laparoscopic approach without major difficulties, based on our larger experience with older children.
Keywords
Abnormalities, Multiple/diagnosis
Age Factors
Body Weight
Esophagoscopy/adverse effects/*methods
Fundoplication/adverse effects/classification/*methods
Gastroesophageal Reflux/complications/diagnosis/*surgery
Gastroscopy/adverse effects/*methods
Humans
Infant
Infant, Newborn
Recurrence
Reoperation
Retrospective Studies
Time Factors
Treatment Outcome
Pubmed
Web of science
Create date
28/01/2008 10:12
Last modification date
20/08/2019 17:05