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Outcome of laparoscopic Nissen–Rossetti fundoplication in children with gastroesophageal reflux disease and supraesophageal symptoms

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Abstract

Background: The role of surgery is debated for children with gastroesophageal reflux disease (GERD), particularly when they show atypical symptoms. This study was designed to evaluate the safety and outcome of laparoscopic Nissen-Rossetti fundoplication performed in a selected population of children with gastroesophageal reflux and atypical supraesophageal symtpoms. Methods: This prospective study included 595 patients younger than 14 years with GERD who reported recurrent respiratory symptoms and had no benefit from standard medical treatment. Surgery was performed for 48 patients with anatomic anomalies, life-threatening events, or respiratory complications after ineffective medical treatment. The subjective and objective outcomes were evaluated. Results: No major intraoperative complications were experienced, and there was no recurrence of gastroesophageal reflux during a postoperative follow-up period of 12 months. The parents’ final subjective evaluation of the outcomes 12 months after surgery was positive in 44 cases and negative in 4 cases. Conclusions: Children with difficult-to-treat chronic respiratory symptoms must be evaluated for GERD, even if the need for surgery is low (8%), because complete eradication of reflux is mandatory. Radical treatment of GERD allows the pulmonologist to perform correct respiratory treatment and to prevent the development chronic and life-threatening complications.

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Acknowledgments

The authors thank Anna Capurro for her English language support. They also thank Francesca Roncallo for her help in administrative support and computerized data collection during the study period.

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Authors and Affiliations

  1. Pediatric Surgery Unit, Giannina Gaslini Research Institute, University of Genova, Largo G. Gaslini 5, 16100 Genoa, Italy

    G. Mattioli, V. Gentilino, F. Martino, A. Pini Prato, M. Castagnetti & V. Jasonni

  2. Pediatric Pulmonology Unit, Giannina Gaslini Research Institute, University of Genova, Largo G. Gaslini 5, 16100 Genoa, Italy

    O. Sacco

  3. Intensive Care Unit and Anesthesiology, Giannina Gaslini Research Institute, University of Genova, Largo G. Gaslini 5, 16100 Genoa, Italy

    G. Montobbio

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  1. G. Mattioli
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  2. O. Sacco
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  3. V. Gentilino
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Correspondence to G. Mattioli.

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Mattioli, G., Sacco, O., Gentilino, V. et al. Outcome of laparoscopic Nissen–Rossetti fundoplication in children with gastroesophageal reflux disease and supraesophageal symptoms . Surg Endosc 18, 463–465 (2004). https://doi.org/10.1007/s00464-003-9108-7

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  • DOI: https://doi.org/10.1007/s00464-003-9108-7

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