Adv Pediatr Surg.  2019 Dec;25(2):51-59. 10.13029/aps.2019.25.2.51.

Comparison of the Surgical Outcomes between Open Fundoplication and Laparoscopic Fundoplication in Children with Gastroesophageal Reflux Disease

• Hong SY
• Yang HB
• Han ST
• Kim HY
• Jung SE

• KMID: 2466400
• DOI: http://doi.org/10.13029/aps.2019.25.2.51

Abstract

PURPOSE
This study aimed to compare the outcomes of open fundoplication (OF) and laparoscopic fundoplication (LF) in children with gastroesophageal reflux disease (GERD).
METHODS
We retrospectively reviewed the electronic medical charts of pediatric patients who underwent fundoplication for GERD between January 2005 and May 2018 at the Korean tertiary hospital. Patient characteristics, operation type, associated diagnosis, operation history, neurologic impairment, postoperative complication, recurrence, and operation outcomes were investigated. The Mann-Whitney U test or Student's t-test was used to evaluate continuous data as appropriate. The χ² test was used to analyze categorical data.
RESULTS
A total of 92 patients were included in this study; 50 were male and 42 were female. Forty-eight patients underwent OF and 44 patients underwent LF. Patient characteristics, such as sex ratio, gestational age, symptoms, neurological impairment, and history of the previous operation were not different between the two groups. A longer operative time (113.0±56.0 vs. 135.1±49.1 minutes, p=0.048) was noted for LF. There was no significant difference in operation time when the diagnosis was limited to only GERD, excluding patients with other combined diseases. Other surgical outcomes, such as intraoperative blood loss, transfusion rate, hospital stay, and recurrence rate were not significantly different between the 2 groups. The complication rate was slightly higher in the OF group than in the LF group; however, the difference was not significant (20.8% vs. 11.4%, p=0.344).
CONCLUSION
LF is as safe, feasible, and effective as OF for the surgical treatment of GERD in children.

Keyword

Gastroesophageal reflux; Fundoplication; Minimally invasive surgical procedures; Pediatrics

MeSH Terms

Child*
Diagnosis
Female
Fundoplication*
Gastroesophageal Reflux*
Gestational Age
Humans
Length of Stay
Male
Minimally Invasive Surgical Procedures
Operative Time
Pediatrics
Postoperative Complications
Recurrence
Retrospective Studies
Sex Ratio
Tertiary Care Centers

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