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Long-term antireflux medication use following pediatric Nissen fundoplication
Steven L Lee1, Roman M Sydorak, Vicki Y Chiu
1Division of Pediatric Surgery, Kaiser Permanente, Los Angeles Medical Center, 4760 Sunset Blvd, Third Floor, Los Angeles, CA 90027, USA. slleemd@yahoo.com
Hypothesis:
Nissen fundoplication decreases the use of antireflux medications.
Design:
Retrospective cohort study using discharge abstract data and pharmacy data.
Setting:
Twelve regional Kaiser Permanente hospitals in southern California.
Patients:
Three hundred forty-two patients underwent Nissen fundoplication.
Intervention:
Nissen fundoplication.
Main Outcome Measure:
Use of antireflux medications.
Results:
The number of patients requiring antireflux medications decreased from 233 patients (68.1%) before Nissen fundoplication to 197 (57.6%) after Nissen fundoplication. Of the 233 patients, 176 (75.6%) were restarted on antireflux medications within 1 year after Nissen fundoplication. Use of antireflux medication decreased in neurologically healthy patients but was unchanged in neurologically impaired children.
Conclusions:
Use of antireflux medication decreased after Nissen fundoplication. Neurologically healthy children showed the biggest decrease in antireflux medication use after Nissen fundoplication.
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