Watson fundoplication in children: a comparative study with Nissen fundoplication.

Area of Science:

• Pediatric surgery
• Gastroenterology
• Surgical outcomes

Background:

• Nissen fundoplication is the standard surgical treatment for reflux in children.
• Watson fundoplication, an anterior approach, was adopted in 1996.
• Watson fundoplication is reported to allow burping and vomiting while reducing gas bloat.

Purpose of the Study:

• To compare the clinical outcomes of Nissen and Watson fundoplications in pediatric patients.
• To evaluate the safety and efficacy of Watson fundoplication against the established Nissen procedure.

Main Methods:

• Retrospective review of 144 children's case notes who underwent open fundoplication (February 1995 - February 2002).
• Comparison of outcomes between 76 Nissen and 55 Watson fundoplications.
• Analysis of complications, dysphagia, and overall clinical outcomes at minimum 1-year follow-up.

Main Results:

• Similar rates of good/excellent outcomes: 85.1% Nissen vs. 88.2% Watson.
• Watson fundoplication showed lower rates of chest infections (1.8% vs. 6.6%) and dysphagia (1.8% vs. 7.9%).
• Both procedures had comparable rates of wound infections and one early death per group.

Conclusions:

• Watson fundoplication is a safe and effective alternative to Nissen fundoplication in children.
• Clinical outcomes for Watson fundoplication are comparable to Nissen fundoplication.
• Watson fundoplication may offer advantages in reducing certain complications like dysphagia and chest infections.