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Esposito, C; Saxena, A; Irtan, S; Till, H; Escolino, M.
Laparoscopic Nissen Fundoplication: An Excellent Treatment of GERD-Related Respiratory Symptoms in Children-Results of a Multicentric Study.
J LAPAROENDOSC ADV S. 2018; 28(8): 1023-1028.
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Autor/innen der Med Uni Graz:
Saxena Amulya Kumar
Till Holger
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Abstract:
Respiratory manifestations of gastroesophageal reflux disease (GERD), particularly chronic cough, are being recognized with increased frequency in children. This survey aimed to investigate the efficacy of laparoscopic Nissen fundoplication for treatment of GERD-related respiratory symptoms not responsive to medical therapy in neurological normal children. We collected data of children with GERD-related respiratory complaints not responsive to medical therapy who underwent laparoscopic Nissen fundoplication in four European centers of Pediatric Surgery over a 10-year period. We excluded children with neurological impairment. A total of 220 laparoscopic Nissen procedures were performed in the period 2005-2015. Twenty-four (12 boys and 12 girls, average age 9.5 years) out of the 220 patients (10.9%) presented with chronic cough and other respiratory manifestations, including asthma, reactive airway disease, and recurrent pneumonia. Average operative time was 65 minutes (range 45-100). As for postoperative complications, two tight wraps requiring endoscopic dilatation (IIIb Clavien) and two relapses of GERD for slipped Nissen requiring reoperation (IIIb Clavien) were recorded. None of these complications occurred in the group of patients with GERD-related respiratory symptoms. At follow-up evaluation, respiratory symptoms disappeared with a significant improvement of quality of life scoring (I Grade Visick) in 22/24 patients (91.6%). Our results confirm that GERD should be investigated as one of the possible etiologic factors in any child with persistent respiratory complaints. In patients with symptoms not responsive to medical therapy, laparoscopic Nissen fundoplication is the treatment of choice with a very high success rate (>90% in our series), a very low morbidity, a significant improvement in airway symptoms, and a marked reduction in the need for medications.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Child -
Europe -
Female -
Fundoplication - adverse effects
Fundoplication - methods
Gastroesophageal Reflux - complications
Gastroesophageal Reflux - surgery
Humans -
Laparoscopy - adverse effects
Laparoscopy - methods
Male -
Operative Time -
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Quality of Life -
Recurrence -
Reoperation - statistics & numerical data
Respiratory Tract Diseases - etiology
Respiratory Tract Diseases - surgery
Retrospective Studies -
Surveys and Questionnaires -
Treatment Outcome -

Find related publications in this database (Keywords)
respiratory symptoms
cough
medical therapy
Nissen
children
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