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[Laparoscopic treatment for gastroesophageal reflux in children]
M de Diego1, J L Peiró, F Vallribera
1Unidad de Cirugía Pediátrica, Hospital de Terrasa, Barcelona.
Insights
Laparoscopic surgery for pediatric gastroesophageal reflux (GER) using Boix-Ochoa or Nissen techniques effectively resolves symptoms. Postoperative outcomes show normal pHmetry and reduced dysphagia with the Boix-Ochoa method.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Context:
- Laparoscopic antireflux surgery is a common treatment for pediatric gastroesophageal reflux (GER).
- Evaluating different surgical techniques is crucial for optimizing patient outcomes.
- Long-term efficacy and side effect profiles require ongoing assessment.
Purpose:
- To evaluate the safety and efficacy of laparoscopic antireflux procedures in pediatric patients.
- To compare the outcomes of the Boix-Ochoa technique versus Nissen fundoplicature for GER.
- To assess postoperative symptoms, pHmetry, and esophageal manometry findings.
Summary:
- Five pediatric patients (ages 6-16) with GER underwent laparoscopic surgery.
- Three patients received the Boix-Ochoa technique, and two received the Nissen fundoplicature.
- All patients demonstrated normal 24-hour pHmetry and absence of vomiting/pyrosis at 3 months post-op. Postoperative dysphagia appeared less frequent with the Boix-Ochoa technique.
Impact:
- Provides evidence for the successful application of laparoscopic antireflux surgery in children.
- Suggests the Boix-Ochoa technique may offer advantages in reducing postoperative dysphagia.
- Contributes to the understanding of surgical management for pediatric GER.
Abstract:
Since 1998 we have operated 5 patients with gastroesophageal reflux (GER) by laparoscopic procedure, aged between 6 and 16 years. In the 3 smaller patients we have done the Boix-Ochoa antireflux technique. In the other 2 patients we have done the Nissen fundoplicature. At 3 months of postoperative course, the 24 hours-pHmetry is normal in all the patients. They also refer the absence of symptomatology of vomiting and/or pyrosis. In 3 patients we could do a postoperative manometry of the distal esophagic sphincter, with normal values. The postoperative dysphagia of the first seems to be lesser in the group treated with the Boix-Ochoa technique.