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Outcomes of surgical fundoplication in children

Mark A Gilger1, Christine Yeh, Jim Chiang

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|November 20, 2004
PubMed

Insights

Fundoplication for pediatric GERD often leads to persistent symptoms, with nearly two-thirds of children requiring further evaluation or treatment. This highlights the need for more research into surgical interventions for gastroesophageal reflux disease in children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Research

Background:

  • Surgical fundoplication is a recommended treatment for persistent gastroesophageal reflux disease (GERD) in children.
  • Associated medical disorders are common in children undergoing fundoplication.

Purpose of the Study:

  • To determine the frequency of postoperative symptoms requiring medical evaluation and/or treatment after fundoplication in children.
  • To compare outcomes in children with and without associated medical disorders.

Main Methods:

  • Retrospective cohort study of children undergoing fundoplication (1996-1999).
  • Data collected on postoperative complications, symptoms, evaluations, medical treatments, and repeat surgeries.
  • Analysis of outcomes based on the presence of associated medical disorders.

Main Results:

  • 198 children underwent fundoplication; 176 (89%) had follow-up within 2 months.
  • 74% of children had associated medical disorders (e.g., neurodevelopmental delay, cystic fibrosis).
  • Children with disorders had higher rates of lung infections (52% vs. 22%) and dumping syndrome (2% vs. 0%). 63% experienced recurrent reflux symptoms requiring evaluation/treatment.

Conclusions:

  • Nearly two-thirds of children followed within 2 months post-fundoplication experienced symptoms or received medical therapy for reflux.
  • Fundoplication for pediatric GERD requires further evaluation due to persistent symptoms.
  • The effectiveness of fundoplication in children with associated medical disorders warrants additional investigation.
Abstract

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