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Operation for gastro-oesophageal reflux associated with severe mental retardation
Insights
Fundoplication surgery for severe gastro-oesophageal reflux in children with mental retardation improved quality of life for most patients. Despite a high complication rate, 81% achieved good results, enhancing well-being for children and caregivers.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Disabilities
Background:
- Severe gastro-oesophageal reflux (GOR) significantly impacts the quality of life for children with severe mental retardation.
- Antireflux surgery is a potential intervention for managing GOR in this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy and safety of fundoplication surgery for severe GOR in children with severe mental retardation.
- To assess the impact of antireflux surgery on the quality of life for affected children and their caregivers.
Main Methods:
- A retrospective study of 176 children with severe mental retardation undergoing fundoplication for GOR.
- Data collection included mortality, complication rates (major and minor), need for revision surgery, and overall outcomes.
Main Results:
- Overall mortality was 6% (early deaths: 3%, late deaths: 3%).
- Major complications occurred in 10% of patients, with minor complications in 49%.
- 81% of children achieved a good outcome, and 15% required revision surgery.
Conclusions:
- Fundoplication surgery can significantly improve the quality of life for children with severe mental retardation and GOR, despite a notable complication rate.
- The benefits of improved quality of life for patients and caregivers may outweigh the risks associated with the surgery.
- Careful patient selection and management are crucial for optimizing outcomes in this complex patient group.
Abstract:
One hundred and seventy six children with severe mental retardation underwent a fundoplication for considerable gastro-oesophageal reflux. There were six 'early' (3%) deaths and five 'late' deaths. Major complications developed in 17 (10%) children whereas 86 (49%) had 'minor' complications. A revision operation was required in 27 patients. Overall 142 (81%) children achieved a good result. In spite of the high complication rate and the need for a secondary operation in 15% of the patients, the quality of life for these children and their parents and carers is greatly improved by antireflux surgery.