Gastrointestinal tract feeding access and the role of fundoplication in combination with gastrostomy

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David A Partrick1

  • 1University of Colorado Health Sciences Center, and Department of Pediatric Surgery, The Children's Hospital, 1056 East 19th Avenue, Denver, CO 80218, USA. partrick.david@tchden.org

Current Opinion in Pediatrics
|May 17, 2007
PubMed

Insights

Pediatric feeding access procedures like gastrostomy and jejunostomy offer low complication rates. While Nissen fundoplication is effective for gastroesophageal reflux, recurrent issues necessitate ongoing innovation.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Minimally invasive techniques

Background:

  • Feeding access and antireflux procedures are common in pediatric surgery.
  • Gastroesophageal reflux disease (GERD) management often requires surgical intervention.

Purpose of the Study:

  • To review current feeding access procedures in pediatric patients.
  • To discuss indications for concurrent antireflux procedures.
  • To explore alternatives to Nissen fundoplication.

Main Methods:

  • Review of current literature on pediatric feeding access.
  • Analysis of endoscopic and laparoscopic techniques for gastrostomy and jejunostomy.
  • Evaluation of outcomes for Nissen fundoplication and alternative antireflux procedures.

Main Results:

  • Endoscopic and laparoscopic gastrostomy/jejunostomy placement demonstrate low complication rates.
  • Laparoscopic Nissen fundoplication is effective for refractory GERD.
  • Recurrent GERD after Nissen fundoplication remains a challenge.

Conclusions:

  • Individualized decisions for long-term feeding access are crucial.
  • Gastrostomy and jejunostomy offer distinct advantages and disadvantages.
  • Innovative solutions are needed to address persistent recurrent GERD post-fundoplication.
Abstract

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