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Antireflux surgery in children with neurological impairment: caregiver perceptions and complications

Edward V O'Loughlin1, Helen Somerville, Albert Shun

  • 1Department of Gastroenterology, Children's Hospital at Westmead, Sydney, Australia.

Journal of Pediatric Gastroenterology and Nutrition
|July 13, 2012
PubMed

Insights

Caregivers reported significant improvements in nutrition and reduced reflux symptoms after antireflux surgery and gastrostomy in children with severe neurological impairment. Serious complications were uncommon, leading to high satisfaction levels.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neurology

Background:

  • Children with severe neurological impairment often experience feeding difficulties and gastroesophageal reflux.
  • Antireflux surgery and gastrostomy are interventions to manage these complications.

Purpose of the Study:

  • To evaluate caregiver perceptions of antireflux surgery and gastrostomy in neurologically impaired children.
  • To report surgical complications associated with these procedures.

Main Methods:

  • Retrospective review of a clinic database for 122 children undergoing antireflux surgery and gastrostomy.
  • Cross-sectional questionnaire administered to 89 caregivers assessing symptom severity using a 5-point Likert scale.

Main Results:

  • The majority of caregivers reported improvements in weight gain, chest infections, vomiting, and feeding tolerance post-surgery.
  • Serious surgical complications occurred in 10% of cases.
  • High caregiver satisfaction was noted, with only 2 regretting the decision for surgery.

Conclusions:

  • Antireflux surgery and gastrostomy are associated with uncommon serious complications in neurologically impaired children.
  • Despite common gagging and retching, caregivers reported improved nutrition and reflux-related symptoms.
  • The procedures led to high levels of caregiver satisfaction and improved quality of life.
Abstract

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