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Laparoscopic Nissen fundoplication in the infant
W R Thompson1, B A Hicks, P C Guzzetta
1Department of Surgery, Division of Pediatric Surgery, University of Texas Southwestern Medical Center at Dallas, Texas, USA.
Journal of Laparoendoscopic Surgery
|March 1, 1996
Summary
Laparoscopic Nissen fundoplication effectively treats severe gastroesophageal reflux (GER) in infants under 8 kg. This minimally invasive surgery shows good short-term results with low complication rates, making it a safe option for small children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Procedures
Background:
- Gastroesophageal reflux (GER) significantly impacts infants, often requiring surgical intervention when conservative treatments fail.
- Very small infants (<8 kg) present unique challenges for surgical management of refractory GER.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic Nissen fundoplication in infants weighing less than 8 kg.
- To assess short-term outcomes, including reflux resolution, morbidity, and mortality.
Main Methods:
- A retrospective review of 25 infants (<8 kg) who underwent laparoscopic Nissen fundoplication between January 1993 and April 1995.
- Data collected included patient demographics, operative details (including gastrostomy), follow-up duration, and clinical outcomes.
Main Results:
- Nineteen of 25 patients (76%) were alive and free of GER symptoms at a mean follow-up of 359 days.
- Mean patient age was 6 months and mean weight was 5.1 kg.
- Perioperative complications were infrequent and mild; 6 late deaths occurred due to underlying conditions, not the procedure.
Conclusions:
- Laparoscopic Nissen fundoplication is an effective and safe antireflux procedure for very small infants with refractory GER.
- The technique offers acceptable short-term morbidity and mortality, providing significant symptom relief.