Restricted accessResearch articleFirst published online 2012-11
Long-Term Outcome of Laparoscopic Nissen Procedure in Pediatric Patients with Gastroesophageal Reflux Disease Measured Using the Modified QPSG Roma III European Society for Pediatric Gastroenterology Hepatology and Nutrition's Questionnaire
Laparoscopic fundoplication (LF) represents the gold standard for surgical treatment for pediatric patients with gastroesophageal reflux disease (GERD).
Methods:
We report the results of long-term outcome of 36 patients who had undergone LF from January to December 1998, with a follow-up longer than 10 years (range, 11–12 years). The patients were invited, by phone, to undergo a clinical follow-up. All patients underwent the modified European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN)'s Roma III questionnaire; however, only 22 out of 36 patients accepted to be controlled in a day hospital setting, and 10 out of 36 accepted to undergo a telephonic questionnaire. Our study is focused on the data of these 32 patients.
Results:
Twenty-eight out of 32 (87.5%) patients had completely recovered; 4 out of 32 patients (12.5%) had a mild persistent GER; 9 out of 32 patients (28%) referred a mild dysphagia; 21 out of 32 (66%) patients could burp; and only 9 out of 32 (28%) patients could vomit. The cosmetic result was good in 30 out of 32 (94%) patients. The weight/height ratio was satisfactory in 28 out of 32 (87.5%) patients. The quality of life was good in 28 out of 32 (87.5%) patients.
Conclusions:
Our experience shows that the long-term follow-up after LF produces a good clinical result and a good quality of life. The modified ESPGHAN's Roma III questionnaire seems an effective way to check the long-term results, because it avoids submitting patients to long and not well tolerated instrumental exams.
Get full access to this article
View all access options for this article.
References
1.
EspositoC, RothenbergSS, MontupetPh. Can laparoscopy be considered the goldstandard in the management of children with GERD. EspositoC, MontupetPh, RothenbergSS. Gastroesophageal Reflux in Infants and Children. Heidelberg, Germany: Springer, 2004; 183–188.
2.
RudolphCD, MazurLJ, LiptakGS, BakerRD, BoyleJT, CollettiRB, GersonWT, WerlinSL. North American Society for Pediatric Gastroenterology and Nutrition. Guidelinesfor the evaluation and treatment of gastroesophageal reflux in infants and children: Recommendations of the North American society for pediatric gastroenterology and nutrition. J Pediatr Gastroenterol Nutr, 2001; 32:1–31.
3.
FonkalsrudEW, AshcraftKW, CoranAG, EllisDG, GrosfeldJL, TunellWP, WeberTR. Surgical treatment of gastroesophageal reflux in children: A combined hospitalstudy of 7467 patients. Pediatrics, 1998; 101:419–422.
4.
MattioliG, SaccoO, GentilinoV, MartinoF, Pini PratoA, CastagnettiM, MontobbioG, JasonniV. Outcome of laparoscopic Nissen-Rossetti fundoplication in children withgastroesophageal reflux disease and supraesophageal symptoms. Surg Endosc, 2004; 18:463–465.
5.
KawaharaH, OkuyamaH, KubotaA, OueT, TazukeY, YagiM, OkadaA. Canlaparoscopic antireflux surgery improve the quality of life in children with neurologic and neuromuscular handicaps?J Pediatr Surg, 2004; 39:1761–1764.
6.
GeorgesonK. Results of laparoscopic antireflux procedures in neurologically normalinfants and children. Semin Laparosc Surg, 2002; 9:172–176.
7.
RothenbergSS. Experience with 220 consecutive laparoscopic Nissenfundoplications in infants and children. J Pediatr Surg, 1998; 33:274–278.
8.
EspositoC, MontupetP, van Der ZeeD, SettimiA, Paye-JaouenA, CentonzeA, BaxNK. Long-term outcome of laparoscopic Nissen, Toupet, and Thal antireflux proceduresfor neurologically normal children with gastroesophageal reflux disease. Surg Endosc, 2006; 20:855–858.
9.
MattioliG, BaxK, BecmeurF, EspositoC, HelouryY, PodevinG, LimaM, MacKinlayGA, GoesslerA, TovarJA, VallaJ, TuoP, NahumL, OttonelloG, SaccoO, GentilinoV, Pini-PratoA, CaponcelliE, JasonniV. European multicenter survey on thelaparoscopic treatment of gastroesophageal reflux in patient aged less than 12 months withsupraesophageal symptoms. Surg Endosc, 2005; 19:1309–1314.
10.
RothenbergSS. The first decade's experience with laparoscopic Nissen fundoplicationin infants and children. J Pediatr Surg, 2005; 40:142–146.
11.
DiazDM, GibbonsTE, HeissK, WulkanML, RickettsRR, GoldBD. Antirefluxsurgery outcomes in pediatric gastroesophageal reflux disease. Am J Gastroenterol, 2005; 100:1844–1852.
SoyerT, KarnakI, TanyelFC, SenocakME, CiftciAO, BüyükpamukçuN. The useof pH monitoring and esophageal manometry in the evaluation of results of surgical therapyfor gastroesophageal reflux disease. Eur J Pediatr Surg, 2007; 17:158–162.
14.
CapitoC, LeclairMD, PiloquetH, PlattnerV, HelouryY, PodevinG. Long-termoutcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children. Surg Endosc, 2008; 22:875–880.
15.
BuonavolontàR, BocciaG, TurcoR, QuitadamoP, RussoD, StaianoA. Pediatric functional gastrointestinal disorders: A questionnaire on pediatric gastrointestinal symptoms based on Rome III criteria. Minerva Pediatr, 2009; 61:67–91.
16.
RasquinA, Di LorenzoC, ForbesD, GuiraldesE, HyamsJS, StaianoA, WalkerLS. Childhood functional gastrointestinal disorders: Child/adolescent. DrossmanDA. Rome III. The Functional Gastrointestinal Disorders, Third. Mclean, VA: Degnon Associates, 2005; 963–990.
17.
DallemagneB, WeertsJ, MarkiewiczS, DewandreJM, WahlenC, MonamiB, JehaesC. Clinical results of laparoscopic fundoplication at ten years after surgery. Surg Endosc, 2006; 20:159–165.
DiazDM, GibbonsTE, HeissK, WulkanML, RickettsRR, GoldBD. Antireflux surgery outcomes in pediatric gastroesophageal reflux disease. Am J Gastroenterol, 2005; 100:1844–1852.
24.
KimberC, KielyEM, SpitzL. The failure rate of surgery for gastro-oesophageal reflux. J Ped Surg, 1998; 33:64–66.
25.
NgernchamM, BarnhartDC, HaricharanRN, RosemanJM, GeorgesonKE, HarmonCM. Risk factors for recurrent gastroesophageal reflux disease after fundoplication in pediatric patients: A case-control study. J Pediatr Surg, 2007; 42:1478–1485.
26.
EspositoC, BecmeurF, CentonzeA, SettimiA, AmiciG, MontupetP. Laparoscopic reoperation following unsuccessful antireflux surgery in childhood. Semin Lap Surg, 2002; 3:179–182.
27.
EspositoC, MontupetP, AmiciG, DesruelleP. Complications of laparoscopicantireflux surgery in childhood. Surg Endosc, 2000; 7:658–660.
28.
SubramaniamR, DicksonAP. Long-term outcome of Boix- Ochoa and Nissen fundoplication in normal and neurologically impaired children. J Ped Surg, 2000; 35:1214–1216.
29.
FearmontiRM, BondJE, ErdmannD, LevinLS, PizzoSV, LevinsonH. The modified patient and observer scar assessment scale: A novel approach to defining pathologic and nonpathologic scarring. Plast Reconstr Surg, 2011; 127:242–247.
30.
PacilliM, ChowdhuryMM, PierroA. The surgical treatment of gastro-esophageal reflux in neonates and infants. Semin Pediatr Surg, 2005; 14:34–41.
31.
LeeSL, SydorakRM, ChiuVY, HsuJW, ApplebaumH, HaighPI. Long-term antireflux medication use following pediatric Nissen fundoplication. Arch Surg, 2008; 143:873–876.
32.
EspositoC. Fundoplication certainly a friend for children with GERD if the indication for surgery is correct. J Pediatr Gastroenterol Nutr, 2003; 7:543–544.
