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Effectiveness of fundoplication in early infancy
1Institute of Child Health and Great Ormond Street Hospital for Children, University College London Medical School, England.
Journal of Pediatric Surgery
|March 3, 1999
Summary
Fundoplication in infants under 4 months has mixed results, with higher failure rates in those with anomalies. Early surgery is best for vomiting and respiratory issues, not failure to thrive.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Gastroesophageal reflux (GER) is a common condition in infants.
- Fundoplication is a surgical procedure to treat GER.
Purpose of the Study:
- To evaluate the outcomes of fundoplication in infants younger than 4 months.
- To identify factors influencing the success of early-life fundoplication.
Main Methods:
- Retrospective review of 66 infants under 4 months who underwent fundoplication.
- Diagnosis of GER confirmed by barium meal or 24-hour pH monitoring.
- Follow-up duration averaged 24 months.
Main Results:
- Fundoplication was performed at a median age of 9 weeks.
- Infants with isolated GER showed a 90% clinical improvement, compared to 64% with associated anomalies.
- Vomiting and respiratory symptoms improved in 76% and 66% of infants, respectively.
- Revision surgery was needed in 24% of patients.
Conclusions:
- Fundoplication in early infancy has a high failure rate, particularly in infants with congenital anomalies.
- Associated anomalies significantly impact the success of fundoplication.
- Infants with emesis and respiratory symptoms experienced the best outcomes.