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Fundoplication in children: experience with 106 cases
A J Spillane1, B Currie, E Shi
1Department of Surgery, Prince of Wales Children's Hospital, Randwick, New South Wales, Australia.
Insights
Fundoplication surgery effectively treats severe infant gastro-oesophageal reflux (GOR) when medical options fail. While generally safe, neurologically impaired children face higher risks, highlighting the need for careful management.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Gastro-oesophageal reflux (GOR) is common in infants, sometimes becoming severe.
- Fundoplication is an effective surgical option for refractory GOR.
Purpose of the Study:
- To review the experience with fundoplication at Prince of Wales Children Hospital (POWCH).
- To assess the safety and efficacy of fundoplication in pediatric patients.
Main Methods:
- Retrospective review of hospital records and surgical database.
- Analysis of 106 fundoplications performed between February 1989 and March 1993.
Main Results:
- The study reported a 7.5% failure rate and a 7.8% long-term mortality rate.
- Neurologically impaired children were identified as having the highest risk for mortality and morbidity.
Conclusions:
- Fundoplication is a safe and potentially life-saving procedure for severe pediatric GOR.
- Special considerations are necessary for neurologically impaired children undergoing this surgery.
Background:
Gastro-oesophageal reflux (GOR) is a physiological problem in infancy that can become pathological and life-threatening in certain cases. Fundoplication has been shown previously to be effective in the control of this problem when medical therapy fails.
Methods:
A retrospective review of the hospital records and the Department of Paediatric Surgery database was carried out, in order to demonstrate the Prince of Wales Children Hospital's (POWCH) experience with 106 fundoplications between February 1989 and March 1993.
Results:
There was a failure rate of 7.5% and a long-term mortality rate of 7.8%. The children most at risk of mortality and morbidity are shown to be the neurologically impaired. The special problems associated with these children as compared with neurologically normal children with pathological GOR are discussed and the literature reviewed.
Conclusion:
Fundoplication is shown to be a safe operation that can be life-saving in certain circumstances.