Outcomes of fundoplication in children with cystic fibrosis

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R Paul Boesch1, James D Acton

  • 1Division of Pediatric Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. paul.boesch@cchmc.org

Journal of Pediatric Surgery
|August 21, 2007
PubMed

Insights

Fundoplication in children with cystic fibrosis (CF) shows a high rate of recurrent gastroesophageal reflux disease (GERD) and no significant nutritional or pulmonary benefits. Careful evaluation is needed for its role in CF management.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pulmonology

Background:

  • Cystic fibrosis (CF) is frequently associated with gastroesophageal reflux disease (GERD).
  • GERD in CF patients can exacerbate chronic respiratory symptoms and feeding difficulties.
  • Fundoplication is a surgical option for GERD, but its outcomes in CF are not well-documented.

Purpose of the Study:

  • To evaluate the outcomes of fundoplication in children with cystic fibrosis.
  • To assess complications, recurrent GERD, and impact on nutritional and pulmonary parameters post-fundoplication.

Main Methods:

  • Retrospective review of 25 children with CF who underwent fundoplication.
  • Collected data on symptoms, diagnostic tests, and complications.
  • Compared nutritional parameters and pulmonary function (FEV1 slope) before and after surgery.

Main Results:

  • No mortality, but 12% experienced complications requiring further surgery.
  • 28% discontinued antireflux medications; 48% developed recurrent GERD.
  • No significant changes in BMI or BMI percentile; FEV1 slope improved only in those with moderate-severe lung disease.

Conclusions:

  • Fundoplication complication rates in CF are comparable to non-CF pediatric populations.
  • High recurrence of GERD and limited nutritional/pulmonary benefits observed.
  • Further evaluation of fundoplication's role in CF is warranted, especially considering lung disease severity.
Abstract

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