INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

Introduction

Gastro-esophageal reflux (GOR) is one of the most prevalent foregut diseases in pediatric patients. When medical treatment fails, the surgical approach is considered as the treatment of choice

Aims

Evaluate the long term outcomes of fundoplication performed in our department

Materials and methods

We retrospectively analyzed all patients who underwent Nissen fundoplication in 6 consecutive years from 2014 to 2019 at our department of pediatric Surgery

Results

Over 6 years, 32 patients who consecutive underwent a Nissen fundoplication were included, for 40 procedures in total. There were 20 (62,5 %) males. At the time of first intervention, median age was 28 months and median weight was 11,5 kg. Overall comorbidities were 5, all neurological impairments and no neuromuscular disorders were reported. 30 patients underwent laparoscopic Nissen fundoplication. There was no operation-related death during the study period. No immediate postoperative complications were reported and all our patients were feed on the first day after surgery except for those with neurological impairment. Median hospital stay was 4,1 days. Incidence of dysphagia 3 months after surgery was 23%. 10% of patients had recurrent symptoms at 4 years. Severe dysphagia requiring endoscopy was observed in 2 patients. Overall, only one patient required a redo-fundoplication. The mean follow-up time was 24,4 months. Overall, after surgery, Patients’ and parents’ perspectives proved to be excellent (no symptoms) or good (mild occasional symptoms easily controlled) in 25 children (78,1 %)

Conclusion

Laparoscopic anti-reflux surgery is of value in children with gastroesophageal reflux disease and long-term results after surgical treatment of GERD by Nissen fundoplication are satisfactory with notably a progressive improvement of symptoms