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Long-term effects of fundoplication in children with chronic airway diseases

G Frongia1, P Ahrens2, I Capobianco1

  • 1Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany.

Journal of Pediatric Surgery
|January 20, 2015
PubMed

Insights

Laparoscopic Thal fundoplication significantly improved airway symptoms and reduced medication needs in children with chronic airway diseases (CAD) and gastroesophageal reflux disease (GERD). This surgical intervention is effective and safe for patients unresponsive to medical management.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pulmonology

Background:

  • The link between chronic airway diseases (CAD) and gastroesophageal reflux disease (GERD) is recognized, but definitive causal links remain unclear.
  • This study investigates the effectiveness of laparoscopic Thal fundoplication as a treatment for children experiencing both CAD and GERD.

Purpose of the Study:

  • To evaluate the therapeutic efficacy of laparoscopic Thal fundoplication in pediatric patients with medically refractory CAD and GERD.
  • To assess the impact of the surgery on airway symptom resolution, medication requirements, and patient satisfaction.

Main Methods:

  • Retrospective analysis of 182 neurologically nonimpaired children who underwent laparoscopic Thal fundoplication.
  • Evaluation of clinical response, medication weaning success (oral and inhaled), and postoperative satisfaction.

Main Results:

  • Complete resolution of main symptoms in 68.7% and marked improvement in 22% of patients.
  • Medication discontinuation achieved in 70.1-96.4% of cases, with reductions in 1.8-23.5%.
  • Low complication rates: one intraoperative gastric perforation, 1% Dumping Syndrome, and 4.3% temporary dysphagia.

Conclusions:

  • Laparoscopic Thal fundoplication is an effective and safe treatment for neurologically intact children with CAD and GERD.
  • The procedure leads to significant airway symptom improvement and reduced medication dependence in children refractory to medical therapy.
  • Laparoscopic Thal fundoplication is a valuable therapeutic option for this patient population.
Abstract

Keywords:
AsthmaChildrenChronic airway diseaseGastroesophageal reflux diseaseLaparoscopic Thal fundoplication

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