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Trends in fundoplication volume for pediatric gastroesophageal reflux disease

Nathan L Maassel1, Matthew P Shaughnessy1, Daniel G Solomon1

  • 1Yale University School of Medicine, Department of Surgery, Division of Pediatric Surgery, New Haven, CT, USA.

Journal of Pediatric Surgery
|March 22, 2021
PubMed

Insights

Pediatric fundoplication for GERD has decreased threefold over the past decade. This trend impacts surgical training, with fewer cases logged by pediatric surgery fellows, reflecting shifts in managing severe pediatric GERD.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Surgical education

Background:

  • Fundoplication is a common procedure for pediatric gastro-esophageal reflux disease (GERD).
  • Recent data on fundoplication trends in children are lacking.
  • Changes in procedure volume affect surgical training and care for severe GERD.

Purpose of the Study:

  • To document trends in pediatric fundoplication volume from 2010-2019.
  • To assess the impact of these trends on pediatric surgical trainees.
  • To analyze changes in the management of severe GERD in children.

Main Methods:

  • Utilized the Pediatric Health Information System (PHIS) database (2010-2019).
  • Analyzed ICD-9/ICD-10 codes for GERD, fundoplication, and gastrostomy.
  • Examined institutional surgical volume, patient demographics, and fellow case logs.

Main Results:

  • Mean institutional fundoplication volume decreased by threefold (50 to 17 cases).
  • Fellow case logs showed an almost twofold decrease in fundoplication volume (46 to 26 cases).
  • Patient characteristics remained consistent; trends were similar across institutions.

Conclusions:

  • Pediatric fundoplication volume has significantly declined over the last decade.
  • This decrease is reflected in the training of pediatric surgery fellows.
  • The findings highlight evolving management strategies for pediatric GERD.
Abstract

Keywords:
Cross-sectionalFundoplicationGastroesophageal reflux diseaseIII, retrospectiveLevel of EvidencePediatric surgeryTrends

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