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Gwak, Jung, Lee, and Seo: Comparison between Laparoscopic and Open Nissen Fundoplication in Pediatric Patients
Original Article
Journal of the Korean Association of Pediatric Surgeons

Journal of the Korean Association of Pediatric Surgeons 2012; 18(2): 59-67.

Published online: 31 December 2012

DOI: https://doi.org/10.0000/jkaps.2012.18.2.59

Comparison between Laparoscopic and Open Nissen Fundoplication in Pediatric Patients

Hong-Ki Gwak, M.D., Soo-Min Jung, M.D., Suk-Koo Lee, M.D., Jeong-Meen Seo, M.D.

Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence: Jeong-Meen Seo, M.D., Division of Pediatric Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-Dong, Kangnam-Gu, Seoul 135-710, Korea. Tel: 02)3410-0282, Fax: 02)3410-0040, jm0815.seo@samsung.com

Received 16 August 2012       Accepted 10 December 2012

Copyright © 2012 Korean Association of Pediatric Surgeons

Abstract

Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p = 0.032).Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p = 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

Keywords: Laparoscopic surgery, Nissen operation, fundoplication, Gastroesophageal reflux, Child

Figures and Tables

Fig. 1
Number of laparoscopic and open fundoplication from 1994 to 2009
jkaps-18-59-g001
Table 1
The Demographic Findings of Patients
jkaps-18-59-i001

(P value: Student T test and Pearson Chi-square)

Table 2
Postoperative Result of Laparoscopic versus Open Fundoplication
jkaps-18-59-i002

(P-value: Fisher's Exact Test)

*Cause of Re-operation (Gastrostomy problem/Recurrence/Other problems)

Table 3
Comparison of the Postoperative Results Considering Underlying Diseases
jkaps-18-59-i003

Abbreviations: NI; neurologic impairment, Prev. OP; previous operation, HH; Hiatal hernia, GERD; gastroesophageal reflux disease, CHD; congenital heart disease, EA; esophageal atresia, L; laparoscopy, O; open surgery, op; operation, BW; body weight, Analg; analgesics, Hosp; Hospital stay, POD; postoperative day, Sx; symptom, Cx; complication.

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