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Title: Laparoscopic Nissen fundoplication in infants and children: analysis of 106 consecutive patients with special emphasis in neurologically impaired vs. neurologically normal patients
Authors: Mathei, Jan ×
Coosemans, Willy
Nafteux, Philippe
Decker, Georges
De Leyn, Paul
Van Raemdonck, Dirk
Hoffman, Ilse
De Boeck, Christiane
Proesmans, Marijke
Lerut, Antoon #
Issue Date: 18-Oct-2007
Publisher: Springer International
Series Title: Surgical endoscopy: ultrasound and interventional techniques vol:22 issue:4 pages:1054-1059
Abstract: BACKGROUND: The laparoscopic Nissen fundoplication has become a frequently performed procedure in infants and children who suffer from gastroesophageal reflux disease (GERD). In this study we describe our 8-year experience with 106 consecutive laparoscopic Nissen fundoplications. METHODS: From January 1994 to May 2002, we included 106 consecutive patients (57 neurologically normal (NN) and 49 neurologically impaired (NI)). The indications were symptomatic GERD, pulmonary symptoms or a combination of both. Patient's outcome was assessed by symptom evaluation, technical examinations and a questionnaire. RESULTS: Mortality was 0% and conversion rate was 2.8%. Major postoperative complications occurred in 12 patients, mostly neurologically impairment. Dysphagia occurred in 23 patients of which 4 required dilatations and 2 a redo Nissen. Gas bloating occurred in 15 children, with spontaneous regression in all. Recurrent pneumopathies were seen in four children. Documented recurrence of reflux occurred in three symptomatic patients. Redo laparoscopic surgery was performed in six patients. A questionnaire was sent to each patient's parents. This showed that most patients had a normal or clearly improved quality of life (93.1% NN, 90.5% NI). Most patients were satisfied with the result and up to 39.5% gave a maximum satisfaction score. CONCLUSION: The laparoscopic Nissen fundoplication can safely be performed with a low conversion rate and no surgical mortality in neurologically normal and neurologically impaired children. Neurologically impaired children are more susceptible to per- and postoperative complications. A good quality of life and a high index of satisfaction could be achieved in most patients.
URI: 
ISSN: 0930-2794
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
Laboratory of Abdominal Transplantation
Pediatric Pulmonology Section (-)
× corresponding author
# (joint) last author

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