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Fundoplication and gastrostomy
1Department of Surgery, The University of Alabama at Birmingham, The Children's Hospital of Alabama 35233, USA.
Insights
Laparoscopic fundoplication and gastrostomy are common pediatric procedures. This approach offers reduced complications for gastroesophageal reflux disorders and failure to thrive in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Fundoplication and gastrostomy are frequently performed in pediatric patients.
- Laparoscopic approaches are increasingly favored due to decreased morbidity.
- These procedures address significant gastroesophageal reflux disorders, swallowing difficulties, and failure to thrive.
Purpose of the Study:
- To review the indications and techniques for laparoscopic fundoplication and gastrostomy in children.
- To present the authors' experience with 390 pediatric patients undergoing these procedures.
Main Methods:
- Review of indications for fundoplication and gastrostomy.
- Description of laparoscopic surgical techniques.
- Analysis of patient data from 390 cases.
Main Results:
- Laparoscopic fundoplication (with or without gastrostomy) is an acceptable approach for pediatric patients with significant gastroesophageal reflux.
- Diagnostic evaluations for reflux remain consistent regardless of surgical approach.
- Gastrostomy alone is indicated for swallowing issues or failure to thrive when reflux is excluded.
Conclusions:
- Laparoscopic fundoplication and gastrostomy are effective and well-tolerated procedures in pediatric surgery.
- The minimally invasive approach enhances patient outcomes for specific gastrointestinal conditions.
- Careful patient selection based on diagnostic evaluations is crucial for successful outcomes.
Abstract:
Fundoplication and gastrostomy are among the most frequently performed procedures in infants and children. A laparoscopic approach with decreased morbidity has made fundoplication (with or without gastrostomy) more acceptable for patients who have significant gastroesophageal reflux disorders. Diagnostic evaluations to determine the presence of pathological gastroesophageal reflux have remained the same for patients being considered for open or laparoscopic procedures. Gastrostomy alone also is performed for patients who have swallowing difficulties or failure to thrive, after excluding the presence of gastroesophageal reflux. The authors review the indications and techniques of laparoscopic fundoplication and gastrostomy, as well as their experience with 390 patients.