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Laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease in infants

Ling Leung1, Carol Wing Yan Wong, Patrick Ho Yu Chung

  • 1Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong.

Pediatric Surgery International
|October 29, 2014
PubMed

Insights

Laparoscopic Nissen fundoplication is safe and effective for infants with gastro-oesophageal reflux disease (GERD), showing outcomes comparable to older children. This procedure offers a shorter operative duration and low recurrence rates for infant GERD management.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Limited data exists on laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease (GERD) in infants.
  • This study describes the experience with this procedure in children, focusing on infants under 12 months.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic Nissen fundoplication in infants compared to older children.
  • To assess surgical outcomes, including operative time, complications, and recurrence rates.

Main Methods:

  • Retrospective review of paediatric patients who underwent laparoscopic fundoplication for GERD between 1998 and 2013.
  • Patients were divided into two groups: infants (0-12 months) and older children (>12 months).
  • Data collected included indications, demographics, operative time, blood loss, conversions, complications, recurrences, and hospitalization duration.

Main Results:

  • 86 patients were reviewed (21 infants, 65 older children).
  • Operative time was shorter in infants (157 min vs. 169 min).
  • Surgical outcomes were comparable between groups, with low recurrence (0% vs. 3%) and complication rates (9.5% vs. 6%).
  • A significant portion of infants (76%) did not develop pneumonia post-procedure.

Conclusions:

  • Laparoscopic Nissen fundoplication is a safe and effective procedure for infants with GERD.
  • Outcomes are comparable to older patients, with a shorter operative duration.
  • The study recommends considering laparoscopic Nissen fundoplication for managing infant GERD due to its low recurrence rate.
Abstract

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