Abstract
Purpose: Neurologically impaired children (NIC) often have swallowing difficulties, severe gastroesophageal reflux, recurrent respiratory infections, and malnutrition. Bianchi proposed esophagogastric dissociation (EGD) as an alternative to fundoplication and gastrostomy. The authors compared these 2 approaches. Methods: Twenty-nine consecutive symptomatic NIC refractory to medical therapy were enrolled in a prospective study and divided into 2 groups: A (n = 12), NIC who underwent fundoplication and gastrostomy; B (n = 14), NIC who underwent EGD. Three were excluded because of previous fundoplication. Anthropometric (percentage of the 50th percentile/ age of healthy children) and biochemical parameters, respiratory infections per year, hospitalization (days per year), feeding time (minutes), and "quality of life" (parental psychological questionnaire, range 0 to 60), were analyzed (t test and Mann-Whitney test) preoperatively and 1 year post-operatively. Complications were recorded. Results: Compared with group A, group B presented a statistically significant increase of all anthropometric and nearly all biochemical parameters with a statistical difference in terms of respiratory infections, hospital stay, feeding time, and psychological questionnaire. In group A, 2 bowel obstructions, 1 tight fundoplication, 1 dumping syndrome, and 3 failures of fundoplication occurred. Group B presented 1 anastomotic stricture, 1 paraesophageal hernia, and 1 bowel obstruction. Conclusions: Compared with fundoplication and gastrostomy, EGD offered better nutritional rehabilitation, reduction in respiratory infections, and improved quality of life. EGD can be rightfully chosen as a primary procedure.
| Original language | English |
|---|---|
| Pages (from-to) | 677-680 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 36 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2001 |
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Keywords
- Fundoplication
- Gastroesophageal reflux
- Neurologically impaired children
- Quality of life
ASJC Scopus subject areas
- Surgery
Cite this
Esophagogastric dissociation versus fundoplication : Which is best for severely neurologically impaired children? / Gatti, C.; Di Abriola, G. Federici; Villa, M.; De Angelis, P.; Laviani, R.; La Sala, E.; Dall'Oglio, L.
In: Journal of Pediatric Surgery, Vol. 36, No. 5, 2001, p. 677-680.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Esophagogastric dissociation versus fundoplication
T2 - Which is best for severely neurologically impaired children?
AU - Gatti, C.
AU - Di Abriola, G. Federici
AU - Villa, M.
AU - De Angelis, P.
AU - Laviani, R.
AU - La Sala, E.
AU - Dall'Oglio, L.
PY - 2001
Y1 - 2001
N2 - Purpose: Neurologically impaired children (NIC) often have swallowing difficulties, severe gastroesophageal reflux, recurrent respiratory infections, and malnutrition. Bianchi proposed esophagogastric dissociation (EGD) as an alternative to fundoplication and gastrostomy. The authors compared these 2 approaches. Methods: Twenty-nine consecutive symptomatic NIC refractory to medical therapy were enrolled in a prospective study and divided into 2 groups: A (n = 12), NIC who underwent fundoplication and gastrostomy; B (n = 14), NIC who underwent EGD. Three were excluded because of previous fundoplication. Anthropometric (percentage of the 50th percentile/ age of healthy children) and biochemical parameters, respiratory infections per year, hospitalization (days per year), feeding time (minutes), and "quality of life" (parental psychological questionnaire, range 0 to 60), were analyzed (t test and Mann-Whitney test) preoperatively and 1 year post-operatively. Complications were recorded. Results: Compared with group A, group B presented a statistically significant increase of all anthropometric and nearly all biochemical parameters with a statistical difference in terms of respiratory infections, hospital stay, feeding time, and psychological questionnaire. In group A, 2 bowel obstructions, 1 tight fundoplication, 1 dumping syndrome, and 3 failures of fundoplication occurred. Group B presented 1 anastomotic stricture, 1 paraesophageal hernia, and 1 bowel obstruction. Conclusions: Compared with fundoplication and gastrostomy, EGD offered better nutritional rehabilitation, reduction in respiratory infections, and improved quality of life. EGD can be rightfully chosen as a primary procedure.
AB - Purpose: Neurologically impaired children (NIC) often have swallowing difficulties, severe gastroesophageal reflux, recurrent respiratory infections, and malnutrition. Bianchi proposed esophagogastric dissociation (EGD) as an alternative to fundoplication and gastrostomy. The authors compared these 2 approaches. Methods: Twenty-nine consecutive symptomatic NIC refractory to medical therapy were enrolled in a prospective study and divided into 2 groups: A (n = 12), NIC who underwent fundoplication and gastrostomy; B (n = 14), NIC who underwent EGD. Three were excluded because of previous fundoplication. Anthropometric (percentage of the 50th percentile/ age of healthy children) and biochemical parameters, respiratory infections per year, hospitalization (days per year), feeding time (minutes), and "quality of life" (parental psychological questionnaire, range 0 to 60), were analyzed (t test and Mann-Whitney test) preoperatively and 1 year post-operatively. Complications were recorded. Results: Compared with group A, group B presented a statistically significant increase of all anthropometric and nearly all biochemical parameters with a statistical difference in terms of respiratory infections, hospital stay, feeding time, and psychological questionnaire. In group A, 2 bowel obstructions, 1 tight fundoplication, 1 dumping syndrome, and 3 failures of fundoplication occurred. Group B presented 1 anastomotic stricture, 1 paraesophageal hernia, and 1 bowel obstruction. Conclusions: Compared with fundoplication and gastrostomy, EGD offered better nutritional rehabilitation, reduction in respiratory infections, and improved quality of life. EGD can be rightfully chosen as a primary procedure.
KW - Fundoplication
KW - Gastroesophageal reflux
KW - Neurologically impaired children
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=0035025223&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035025223&partnerID=8YFLogxK
U2 - 10.1053/jpsu.2001.22935
DO - 10.1053/jpsu.2001.22935
M3 - Article
C2 - 11329564
AN - SCOPUS:0035025223
VL - 36
SP - 677
EP - 680
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -