Abstract
In order to compare the standard Nissen fundoplication with the more recent Angelchik anti-reflux prosthesis, 20 pediatricsized, developmentally disabled patients were prospectively randomized to receive either of these gastroesophageal anti-reflux procedures. The two groups were comparable at the time of surgery with regard to age, weight, surface area, preceding weight gain, emesis, number of chest x-rays, medications, lower esophageal sphincter pressure and number and duration of reflux episodes during standard acid reflux testing. The Angelchik group required significantly less anesthesia time than the Nissen group, 111.7±19.7 min (mean±SD) vs. 163.8±24.8 min (p < .001). There was no difference in length of post-surgical hospital stay. Six months after surgery, both techniques were effective, and no differences were seen between the two groups in the following evaluations: mean subjective assessment scores; decreases in emesis, numbers of chest radiographs, hospital days or medications; increased lower esophageal sphincter pressure; or decreased numbers and duration of reflux episodes during acid reflux testing. The Nissen group gained significantly more weight during the 6 months after surgery, 9.8±4.6 lb (mean±SD) vs. 2.4±4.4 lb (p < .01). Further study of this recent surgical development is indicated.
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Gourley, G., Pellett, J., Li, B. et al. A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND STUDY OF GASTROESOPHAGEAL REFLUX SURGERY: NISSEN FUNDOPLICATION VS.ANGELCHIK PROSTHESIS. Pediatr Res 18 (Suppl 4), 196 (1984). https://doi.org/10.1203/00006450-198404001-00620
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DOI: https://doi.org/10.1203/00006450-198404001-00620