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Fundoplication and pediatric esophageal manometry: actuarial analysis over 7 years
J C Opie1, H Chaye, G C Fraser
1Department of Cardiothoracic Surgery, BC Children's Hospital, Vancouver.
Journal of Pediatric Surgery
|October 1, 1987
Summary
This study evaluated antireflux surgery in 61 children, finding a 7-year event-free survival of 62%. Manometric calibration yielded uniform results but no superiority over simpler techniques for preventing overly tight repairs.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Gastroesophageal reflux (GER) and its complications significantly impact children's health.
- Surgical intervention is often necessary for severe cases unresponsive to medical management.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of antireflux surgical procedures in pediatric patients.
- To assess the impact of manometric calibration on surgical outcomes.
Main Methods:
- A retrospective analysis of 73 antireflux surgeries performed on 61 children and infants.
- Esophageal manometry was utilized preoperatively, intraoperatively, and postoperatively.
- Actuarial methods were employed for long-term outcome evaluation over a 7-year follow-up period.
Main Results:
- Ninety-four percent patient survival was observed over the 7-year follow-up.
- The 7-year actuarial event-free survival rate was 62%, with all events occurring within 18 months.
- The 7-year actuarial failure rate for fundoplication was 24% using this technique.
Conclusions:
- Manometric calibration of antireflux procedures in pediatric patients leads to uniform results.
- This technique, while effective, did not demonstrate superiority over simpler methods using a rubber bougie to prevent overly tight repairs.