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Risk factors of dumping syndrome after fundoplication for gastroesophageal reflux in children

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Abstract

Purpose

In postoperative cases of fundoplication, the gastric emptying ability is promoted and sometimes exhibits dumping syndrome. Dumping syndrome often goes unrecognized in children. Furthermore, the risk factors for postoperative dumping syndrome are unknown. This study aimed to investigate the risk factors of developing dumping syndrome after fundoplication.

Methods

A retrospective chart review of all consecutive patients between January 2003 and March 2018 (190 patients) who had fundoplication at our clinic was conducted. Regarding the risk factors of dumping syndrome, gender, age and body weight at the time of surgery, neurological impairment, severe scoliosis, microgastria, chromosomal abnormalities, complex cardiac anomalies, gastrostomy, and laparoscopic surgery were retrospectively studied.

Results

17 patients (9%) developed dumping syndrome post-operatively. Multivariate analysis showed that significant risk factors for dumping syndrome included: undergoing surgery within 12 months of age (adjusted OR 10.3, 95% CI 2.6–45.2), severe scoliosis (adjusted OR 19.3, 95% CI 4.4–91.1), and microgastria (adjusted OR 26.5, 95% CI 1.4–896.4).

Conclusions

We identified that: age at fundoplication being within 12 months of age, severe scoliosis, and microgastria were risk factors for dumping syndrome after fundoplication, and that this information should be explaining to the family before conducting the fundoplication.

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Acknowledgements

The authors thank Drs Seiji Watanabe, Kyoko Suzuki, KeikoYagi, Ayumi Kobayashi, Kana Nakamura, Risa Kuwabara, and Mashriq Alganabi.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Shizuoka Children’s Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan

    Masaya Yamoto, Koji Fukumoto, Toshiaki Takahashi, Hiromu Miyake, Kengo Nakaya, Akiyoshi Nomura, Akinori Sekioka, Yutaka Yamada & Naoto Urushihara

Authors
  1. Masaya Yamoto
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  2. Koji Fukumoto
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  3. Toshiaki Takahashi
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  4. Hiromu Miyake
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  5. Kengo Nakaya
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  6. Akiyoshi Nomura
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  7. Akinori Sekioka
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  8. Yutaka Yamada
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  9. Naoto Urushihara
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Contributions

MY organized this research project and drafted and wrote the manuscript. KF, TT, HM, KN, AN, AS, YY, and NU participated in the study design and helped to draft the manuscript. All authors contributed to the interpretation of the findings and approved the final manuscript.

Corresponding author

Correspondence to Masaya Yamoto.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

We received approval from the institutional ethics committee of Shizuoka Children’s Hospital for this study (Approval Number of 2017056).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yamoto, M., Fukumoto, K., Takahashi, T. et al. Risk factors of dumping syndrome after fundoplication for gastroesophageal reflux in children. Pediatr Surg Int 37, 183–189 (2021). https://doi.org/10.1007/s00383-020-04783-0

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  • DOI: https://doi.org/10.1007/s00383-020-04783-0

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