Esophagogastric disconnection following failed fundoplication for the treatment of gastroesophageal reflux disease (GERD) in children with severe neurological impairment

Silvia Buratti, Rose Kamenwa, Ranjan Dohil, David Collins, Joel E. Lavine

Research output: Contribution to journalArticle


This report describes our experience with esophagogastric disconnection and Roux-en-Y esophagojejunostomy for the treatment of gastroesophageal reflux disease (GERD) in seven neurologically impaired children as a second antireflux operation following failed Nissen fundoplication. After a mean follow-up of 3 years, three children (43%) were completely or almost completely symptom-free and had improved nutritional status. Early complications occurred in three patients (43%): small bowel obstruction, wound infection, and necrosis of the Roux-en-Y loop. Three patients (43%) presented long-term complications: jejunoesophageal bile reflux and bile reflux with gastric irritation. Two patients required reoperation (28%), and two deaths occurred in the postoperative period (28%). In three previous reports in the surgical literature, severe postoperative complications occurred in 0-44%, requiring reoperation in 0-22% of the patients, and the mortality rate was 0-11%. Esophagogastric disconnection for the treatment of GERD in neurologically impaired children is associated with major complications and should be considered after more conservative procedures fail.

Original languageEnglish
Pages (from-to)786-790
Number of pages5
JournalPediatric Surgery International
Issue number10
Publication statusPublished - Oct 2004



  • Antireflux surgery
  • Esophagogastric disconnection
  • Neurologically impaired children

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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