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Laparoscopic fundoplication in children with a preexisting gastrostomy
Hannu Lintula1, Pentti Antila, Hannu Kokki
1Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland. hannu.lintula@kuh.fi
Background:
Children with a gastrostomy may require laparoscopic fundoplication (LF).
Methods:
Children with a gastrostomy who underwent LF between 1998 and 2002 were reviewed. The outcomes of children undergoing LF were compared with a group of children without a gastrostomy who had the same operation during the same period.
Results:
Ten children with a gastrostomy in place and eight children without a gastrostomy underwent LF. The median operating time was 198 minutes (range, 115-300 minutes) in the gastrostomy group and 110 minutes (range, 80-130 minutes) in the non-gastrostomy group (P =.002). In the gastrostomy group, two children had ventriculoperitoneal shunts and two had extensive intra-abdominal adhesions due to peritonitis. One laparoscopic procedure in each group was converted to an open approach. A successful LF was performed in nine of the ten children without taking down the gastrostomy. One child with a gastrostomy experienced recurrent vomiting that was managed with a gastrojejunal tube. One child in the non-gastrostomy group required reoperation due to an esophageal stricture.
Conclusion:
It seems that LF can be performed safely and effectively in children with a preexisting gastrostomy. LF in children with a gastrostomy seems to be as efficacious as LF in children without a gastrostomy.