Related Experiment Video

Updated: Aug 16, 2026

Technical Considerations and Approach to Redo Foregut Surgery
04:14

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Antireflux surgery outcomes in pediatric gastroesophageal reflux disease

Diego M Diaz1, Troy E Gibbons, Kurt Heiss

  • 1Pediatric Gastroenterology and Nutrition, Emory University School of Medicine, Atlanta, Georgia 30322, USA.

The American Journal of Gastroenterology
|August 10, 2005
PubMed

Insights

Laparoscopic Nissen fundoplication (LNF) in children has a higher reoperation rate than open Nissen fundoplication (ONF). Reoperations for both procedures are most common in the first year, with prematurity increasing risk.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Comparative outcomes research

Background:

  • Gastroesophageal reflux disease (GERD) is common in children, often treated with antireflux surgery.
  • Limited comparative data exist for open Nissen fundoplication (ONF) versus laparoscopic Nissen fundoplication (LNF) in pediatric GERD.
  • Understanding reoperation rates is crucial for optimizing surgical management.

Purpose of the Study:

  • To compare reoperation rates and influencing factors for ONF and LNF in pediatric GERD patients.
  • To identify predictors of reoperation after antireflux surgery in children.
  • To assess short- and long-term outcomes of both surgical approaches.

Main Methods:

  • Retrospective cohort study of children aged <=5 years undergoing ONF or LNF between 1997-2002.
  • Data collected included surgical indications, hospital course, and long-term outcomes.
  • Statistical analysis involved univariate and multiple logistic regressions.

Main Results:

  • 456 patients (150 ONF, 306 LNF) were analyzed; 12.06% required reoperation.
  • LNF had a higher reoperation rate (14.05%) compared to ONF (8%).
  • Initial LNF and prematurity were significant predictors for reoperation.

Conclusions:

  • LNF demonstrates a higher reoperation rate than ONF in pediatric GERD.
  • The majority of reoperations for both techniques occur within the first year post-surgery.
  • Comorbidities, particularly prematurity and chronic respiratory conditions, increase the likelihood of reoperation.
Abstract

More Related Videos

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy04:05

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy

Published on: August 22, 2025

Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...