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A Team-Based Approach for Children With Congenital Cardiac Disease Undergoing Antireflux Procedure With Gastrostomy

Adil A Shah1,2, Andrew Matisoff3, Nina Deutsch3

  • 1233494 Department of General and Thoracic Surgery, Children's National Health System, Washington, DC, USA.

The American Surgeon
|October 7, 2020
PubMed

Insights

Laparoscopic Nissen fundoplication with gastrostomy tube (LPNF-GT) placement in children with congenital cardiac diseases (CCDs) is safe. A team-based approach improves operative time without impacting readmissions or mortality.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Cardiology

Background:

  • Laparoscopic Nissen fundoplication with gastrostomy tube (LPNF-GT) placement is crucial for nutritional optimization in children with congenital cardiac diseases (CCDs).
  • Evaluating institutional outcomes of LPNF-GT using a team-based approach is essential.

Purpose of the Study:

  • To assess the safety and efficacy of LPNF-GT in pediatric patients with CCDs.
  • To evaluate the impact of a team-based operative management approach on LPNF-GT outcomes.

Main Methods:

  • A 5-year retrospective review of an institutional database for LPNF-GT in children with CCDs.
  • Propensity score matching with the 2012-2013 national Pediatrics NSQIP database for comparison.
  • Analysis of operative time, unplanned readmission, and 30-day mortality.

Main Results:

  • Fifty-one LPNF-GT cases were performed using a team-based approach.
  • Median operative time was 68.5 minutes; risk-adjusted operative time was 47.38 minutes shorter than national benchmarks (P < .05).
  • No significant differences in 30-day mortality, unplanned readmissions, or prolonged hospital stay compared to national data.

Conclusions:

  • LPNF-GT is a safe procedure for children with CCDs.
  • A team-based approach enhances operative efficiency for LPNF-GT in this population.
  • Institutional LPNF-GT outcomes are comparable to national results.
Abstract

Keywords:
antirefluxcongenital cardiac diseasefeeding tubegastrostomynutritionoutcomesteam-based approach

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