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Safety of laparoscopic fundoplication in children under 5 kg: a comparative study

Jean-Baptiste Marret1,2, Claire Dupont-Lucas3,4, Thierry Petit5

  • 1Department of Pediatric Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14032, Caen Cedex 9, France. marret-jb@chu-caen.fr.

Surgical Endoscopy
|April 1, 2018
PubMed

Insights

Laparoscopic fundoplication (LF) is safe and effective in infants weighing 5 kg or less. This study found no increased complications or operative time compared to heavier infants, supporting its use in low-weight infants.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic fundoplication (LF) safety and efficacy in infants under 5 kg remains debated.
  • Evaluating LF in this low-weight pediatric population is crucial for clinical practice.

Purpose of the Study:

  • To assess the safety and efficacy of laparoscopic fundoplication (LF) in infants weighing 5 kg or less.
  • To compare outcomes between low-weight (≤5 kg) and higher-weight (5.1–10 kg) pediatric patients undergoing LF.

Main Methods:

  • Retrospective review of 96 pediatric patients undergoing LF between 2005 and 2014.
  • Patients were divided into a Low Weight Group (LWG, ≤5 kg) and a High Weight Group (HWG, 5.1–10 kg).
  • Comparison of pre-operative, peri-operative, and post-operative data, including surgical and anesthesia parameters.

Main Results:

  • Operating times and intraoperative respiratory parameters (PCO2) were comparable between LWG and HWG.
  • While LWG infants required more pre-operative respiratory support, post-operative complications were similar between groups.
  • GERD recurrence requiring re-operation was noted in 3 LWG patients and 1 HWG patient.

Conclusions:

  • Laparoscopic fundoplication is a safe and effective procedure for infants weighing 5 kg or less.
  • The procedure does not lead to an increased rate of post-operative complications, recurrence, or operative time in low-weight infants.
  • Findings support the use of LF in this vulnerable pediatric population.
Abstract

Keywords:
ChildrenFundoplicationLaparoscopicMorbidityPrematuritySafety

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