Abstract
Purpose of the Study: To evaluate our 5-year experience with anti-reflux surgery (ARS) and determine the parents' perspective of the outcome.
Methods Used: We conducted a retrospective analysis of the outcome and quality of life as a result of anti-reflux surgery (ARS) performed at Columbus Children's Hospital during 1998–2003. Charts were reviewed for demographic data and surveys were sent out to 491 patients who underwent fundoplication, 119 were returned as address unknown, 65 people returned the survey for a response rate of 17% (65/372) and 4 expressed the desire not to participate. We assessed the outcome and quality of life on 61 patients; age (mean 4 years, median 1), 37 M / 24 F, 75% Caucasian. The primary reason for ARS was FTT n=11 (18%), breathing problems n=25 (41%), and vomiting n=23 (38%). Nissen was performed on 60 and Thal on 1. Surgery was done by an open approach on 54 (88.5%) and by laparoscopic approach on 7 (11.5%). Among the 61 patients, 21(34%) had neurological developmental delay.
Results: Six months after ARS, 32% of patients ate exclusively by mouth compared to 55% prior to surgery (p = 0.001*) and 22% remained on exclusive continuous jejunal feeding compared to 37% prior to ARS (p = 0.09). General overall health score, emotional state and respiratory condition were scored as (poor, fair, good, very good and excellent). Analysis of pre and post ARS values per Wilcox matched pair test revealed significant improvements with p <0.001 in all 3 domains. Limitation of child's activity was scored between none and severe. Statistical analysis revealed significant improvement (p=0.001). Average number of workdays/month missed due to doctor visits was 19.2 compared to 8 post ARS (p=0.022).
Conclusions: 1. Anti-reflux surgery does not improve the oral intake of children with GER. 2. Most children fed via transpyloric access will continue to require this means of feeding after ARS. General quality of life improves after ARS and health care utilization decreases.
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Mousa, H., Woodley, F., Metheney, M. et al. The Long-Term Outcome of Fundoplication in Children With Gastroesophageal Reflux Disease: A Retrospective Analysis.. Pediatr Res 56, 672 (2004). https://doi.org/10.1203/00006450-200410000-00056
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DOI: https://doi.org/10.1203/00006450-200410000-00056