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Pediatric Surgery International

, Volume 34, Issue 7, pp 749–754 | Cite as

Outcomes of laparoscopic nissen fundoplications in children younger than 2-years: single institution experience

  • Armando Rosales
  • Jill Whitehouse
  • Carrie Laituri
  • Glenda Herbello
  • Julie Long
Original Article

Abstract

Background

Variation exists in the diagnostic testing for gastroesophageal reflux (GER) in infants and in the application of surgical therapy. There has been an increase in antireflux surgery (ARS) since the development of laparoscopy but the outcomes in high-risk infants is unclear. This study examines the results of laparoscopic fundoplication in infants less than 2 years.

Methods

The results of infants less than 2 years undergoing laparoscopic Nissen fundoplication (Lap-F) from 2012 to 2015 were retrospectively reviewed and outcomes were followed until 2017.

Results

There were 106 patients, median gestational age 32.50 weeks ± 6.35 SD and non-corrected age at operation 23.0 weeks ± 19.0 SD, mean weight of 4.81 kg ± 2.10 SD. One of the most common reasons for surgical consultation was improvement in respiratory status after insertion of nasoduodenal feeding tube. Of the Lap-F, 100 were with gastrostomy tube (GT). There were no conversions to open or intraoperative complications. The complication rate was 4.71%, and the reoperation rate was 5.66%, one fundoplication revision and the others gastrostomy revisions. The median time for feeds and to reach goal were 1 (1–14) and 4 (2–279) days, respectively. The 30-day mortality was 0.9% and long-term it was 4.71%. The long-term mortality was related to the underlying medical problems. The median follow-up was 113 (3–286) weeks. One patient required revision of the fundoplication and none required esophageal dilatation during the follow-up period.

Conclusion

Fundoplication is effective for relief of symptoms of GER in children younger than 2 years. The procedure has a low morbidity and mortality in this population.

Keywords

Laparoscopic Nissen Fundoplication Gastroesophageal reflux 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors report a conflict of interest.

Ethical approval

This project was approved by the Institutional Review Board of Joe DiMaggio Children’s Hospital.

Informed consent

Informed consent was waived by the committee the study was retrospective and posed no risk to the participants. The study complied with the 1964 Helsinki declaration and its later amendments.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryCleveland Clinic FloridaWestonUSA
  2. 2.Department of Pediatric SurgeryJoe DiMaggio Children’s HospitalHollywoodUSA

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