Esophagogastric dissociation reduces the re-operation rate for persistent gastroesophageal reflux in severely neurologically impaired children

Purpose In this study we want to demonstrate the effectiveness of the esophagogastric dissociation as a first level operation in treatment of the gastroesophageal reflux in severe neurologically impaired children, in term of a reduction of reoperation rate. Methods We divided patients operated from...

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Bibliographic Details
Published in:Pediatric surgery international 2014-10, Vol.30 (10), p.997-1001
Main Authors: Molinaro, F., Bindi, Edoardo, Cerchia, E., Angotti, R., Mariscoli, F., Messina, M.
Format: Article
Language:English
Subjects:
Adolescent
Child
Esophagus - surgery
Female
Fundoplication - methods
Gastroesophageal Reflux - complications
Gastroesophageal Reflux - surgery
Gastrostomy - methods
Humans
Italy
Male
Medicine
Medicine & Public Health
Nervous System Diseases - complications
Original Article
Pediatric Surgery
Pediatrics
Postoperative Complications - prevention & control
Reoperation
Retrospective Studies
Surgery
Treatment Outcome
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Summary:Purpose In this study we want to demonstrate the effectiveness of the esophagogastric dissociation as a first level operation in treatment of the gastroesophageal reflux in severe neurologically impaired children, in term of a reduction of reoperation rate. Methods We divided patients operated from 1998 to 2005 in a group A, composed by children treated with fundoplication, and in a group AR, composed by the patients of group A who had a recurrence of reflux and that was treated with esophagogastric dissociation. Patients operated from 2005 to 2013 were selected on the basis of the severity of the neurological impairment and were divided in a group B, treated with fundoplication, and in a group C of more severe impaired children, treated with esophagogastric dissociation. Data regarding the complications of the A and C groups were analyzed with Fisher’s test. Results We evaluated 63 patients: 34 (54 %) in group A, 11 in group AR, 15 (23.6 %) in group B, 14 (22.4 %) in group C. The Fisher’s test showed a non significant difference with a p value of 0.2. Conclusion Despite of statistic result we believe that TOGD is a useful procedure as the first choice of surgical management in severe neurological impaired children affected by gastroesophageal reflux.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-014-3584-9