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Current status of intractable pediatric gastroesophageal reflux disease in Japan: a nationwide survey

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Abstract

Purpose

A nationwide survey was conducted to investigate the current status of pediatric gastroesophageal reflux disease (GERD) in Japan, with special reference to the characteristics of intractable GERD.

Methods

Data were collected using a questionnaire from facilities specializing in the treatment of pediatric GERD in Japan. Intractable GERD was defined as follows: I, no symptomatic improvement after 8 weeks of optimal medical treatment (OMT) plus fundoplication; II, no symptomatic improvement after 8 weeks of OMT and with no indications for fundoplication; and III, no symptomatic improvement after surgery without OMT.

Results

We collected data from 3,463 pediatric patients with GERD from 91 institutions, and 81 satisfied the definition of intractable GERD. Additional clinical information was obtained from 56 patients, and 41 represented cases of definite intractable GERD. The main underlying disorders included neurological impairment (NI), esophageal atresia (EA), and congenital heart disease (CHD), which altogether accounted for 85% of patients. Of the 41 patients, 33 received fundoplication, and the remaining 8 received medical treatment alone because surgery was considered unsuitable.

Conclusions

The nationwide survey revealed that pediatric intractable GERD is rare in Japan. Three main underlying disorders—NI, EA, and CHD—were implicated in the majority of cases of intractable GERD.

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Acknowledgements

This study was supported by a grant 2017–2019 from the Ministry of Health, Labour Sciences Research Grants for Research on intractable disease (H29-Nanchi-Ippan-015) to Professor Tomoaki Taguchi. The authors thank the 97 certified institutions and the 67 associated facilities of the Japanese Society of Pediatric Surgeons and the 48 affiliated facilities of the representatives of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition that participated in this survey.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Suguru Fukahori, Minoru Yagi, Daisuke Masui & Naoki Hashizume

  2. Department of Pediatric Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Hisayoshi Kawahara

  3. Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Tomoaki Taguchi

Authors
  1. Suguru Fukahori
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  2. Minoru Yagi
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  3. Hisayoshi Kawahara
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  4. Daisuke Masui
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  5. Naoki Hashizume
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  6. Tomoaki Taguchi
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Contributions

All authors contributed to the study conception and design. Material preparation was performed by SF, MY, and HK. Data collection and analysis were performed by SF, DM, and NH. The first draft of the manuscript was written by SF; all authors reviewed the manuscript for intellectual content. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Suguru Fukahori.

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Conflict of interest

The authors declare no conflicts of interest in association with the present study.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The anonymity of all patients was guaranteed. This study was approved by the ethical committee for clinical research at Kurume University, Japan, (approval No. 18215). Furthermore, the study was conducted in accordance with the Ethical Guidelines for Clinical Research published by the Ministry of Health, Labour and Welfare on July 30, 2003.

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Fukahori, S., Yagi, M., Kawahara, H. et al. Current status of intractable pediatric gastroesophageal reflux disease in Japan: a nationwide survey. Surg Today 52, 1153–1159 (2022). https://doi.org/10.1007/s00595-021-02444-w

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  • DOI: https://doi.org/10.1007/s00595-021-02444-w

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