nach oben

Erschienen in:

17.07.2019 | Dysphagie | Leitthema

Anti-Reflux-Chirurgie bei mehrfach behinderten Kindern

verfasst von: PD Dr. med. J.-H. Gosemann, Prof. Dr. med. M. Lacher

Erschienen in: Monatsschrift Kinderheilkunde | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Mehrfach behinderte Kinder haben ein hohes Risiko, im Verlauf ihres Lebens eine gastroösophageale Refluxkrankheit (GÖRK) zu entwickeln. Die symptomorientierte Anamnese und körperliche Untersuchung sind Grundlage einer weiterführenden Diagnostik und Therapie. Symptome einer GÖRK können bei mehrfach behinderten Kindern sehr unspezifisch sein oder fehlen. Atemprobleme, Schluckbeschwerden, unklare Unruhezustände und Verschlechterung der Spastik können hinweisend auf eine GÖRK sein. Wenn die optimierte konservative Therapie nicht erfolgreich ist, besteht die Indikation zur Anti-Reflux-Chirurgie. Hierbei hat sich die laparoskopische Fundoplikatio als minimal-invasive Technik durchgesetzt. Im Langzeitverlauf ist die Rezidivrate der GÖRK unabhängig von der Operationsmethode hoch. Daher ist für die komplexe Behandlung von mehrfach behinderten Patienten mit GÖRK der Einsatz eines multidisziplinären Teams erforderlich.

Rosen R, Vandenplas Y, Singendonk M et al (2018) Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 66:516–554. https://doi.org/10.1097/MPG.0000000000001889 CrossRefPubMedPubMedCentral

Marseglia L, Manti S, D’Angelo G et al (2015) Gastroesophageal reflux and congenital gastrointestinal malformations. World J Gastroenterol 21:8508–8515. https://doi.org/10.3748/wjg.v21.i28.8508 CrossRefPubMedPubMedCentral

Hölscher AC, Laschat M, Choinitzki V et al (2017) Quality of life after surgical treatment for esophageal atresia: long-term outcome of 154 patients. Eur J Pediatr Surg 27:443–448. https://doi.org/10.1055/s-0036-1597956 CrossRefPubMed

Muensterer OJ, Perger L, Hansen EN et al (2011) Single-incision pediatric endosurgical Nissen fundoplication. J Laparoendosc Adv Surg Tech A 21:641–645. https://doi.org/10.1089/lap.2010.0524 CrossRefPubMed

van Wijk M, Knuppe F, Omari T et al (2013) Evaluation of gastroesophageal function and mechanisms underlying gastroesophageal reflux in infants and adults born with esophageal atresia. J Pediatr Surg 48:2496–2505. https://doi.org/10.1016/j.jpedsurg.2013.07.024 CrossRefPubMed

Faure C, Grunder FR (2017) Dysmotility in esophageal atresia: pathophysiology, characterization, and treatment. Front Pediatr. https://doi.org/10.3389/fped.2017.00130 CrossRefPubMedPubMedCentral

Romano C, van Wynckel M, Hulst J et al (2017) European society for paediatric gastroenterology, hepatology and nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment. J Pediatr Gastroenterol Nutr 65:242–264. https://doi.org/10.1097/MPG.0000000000001646 CrossRefPubMed

Del Giudice E, Staiano A, Capano G et al (1999) Gastrointestinal manifestations in children with cerebral palsy. Brain Dev 21:307–311. https://doi.org/10.1016/S0387-7604(99)00025-X CrossRefPubMed

Reyes AL, Cash AJ, Green SH, Booth IW (1993) Gastroesophageal reflux in children with cerebral-palsy. Child Care Health Dev 19:109–118CrossRefPubMed

10.

Bohmer C, Klinkenberg-Knol EC, de Boer R, Meuwissen S (1997) The prevalence of gastro-oesophageal reflux disease based on non-specific symptoms in institutionalized, intellectually disabled individuals. Eur J Gastroenterol Hepatol 9:187–190CrossRefPubMed

11.

Bayram AK, Canpolat M, Karacabey N et al (2016) Misdiagnosis of gastroesophageal reflux disease as epileptic seizures in children. Brain Dev 38:274–279. https://doi.org/10.1016/j.braindev.2015.09.009 CrossRefPubMed

12.

Khoshoo V, Zembo M, King A et al (1996) Incidence of gastroesophageal reflux with whey- and casein-based formulas in infants and in children with severe neurological impairment. J Pediatr Gastroenterol Nutr 22:48–55CrossRefPubMed

13.

Miyazawa R, Tomomasa T, Kaneko H et al (2008) Effects of pectin liquid on gastroesophageal reflux disease in children with cerebral palsy. BMC Gastroenterol. https://doi.org/10.1186/1471-230X-8-11 CrossRefPubMedPubMedCentral

14.

Marchand V, Motil KJ, Committee on Nutrition (2006) Nutrition support for neurologically impaired children: a clinical report of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 43:123–135. https://doi.org/10.1097/01.mpg.0000228124.93841.ea CrossRefPubMed

15.

Bell KL, Samson-Fang L (2013) Nutritional management of children with cerebral palsy. Eur J Clin Nutr 67(Suppl 2):S13–S16. https://doi.org/10.1038/ejcn.2013.225 CrossRefPubMed

16.

Sullivan PB, Morrice JS, Vernon-Roberts A et al (2006) Does gastrostomy tube feeding in children with cerebral palsy increase the risk of respiratory morbidity? Arch Dis Child 91:478–482. https://doi.org/10.1136/adc.2005.084442 CrossRefPubMedPubMedCentral

17.

Sullivan PB, Juszczak E, Bachlet A et al (2005) Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study. Dev Med Child Neurol 47:77–85. https://doi.org/10.1017/S0012162205000162 CrossRefPubMed

18.

Dormann AJ, Huchzermeyer H (2002) Endoscopic techniques for enteral nutrition: Standards and innovations. Dig Dis 20:145–153. https://doi.org/10.1159/000067486 CrossRefPubMed

19.

Kwon RS, Banerjee S, Desilets D et al (2010) Enteral nutrition access devices. Gastrointest Endosc 72:236–248. https://doi.org/10.1016/j.gie.2010.02.008 CrossRefPubMed

20.

Gauderer M, Ponsky JL, Izant RJ (1980) Gastrostomy without laparotomy—a percutaneous endoscopic technique. J Pediatr Surg 15:872–875. https://doi.org/10.1016/S0022-3468(80)80296-X CrossRefPubMed

21.

Georgeson KE (1993) Laparoscopic gastrostomy and fundoplication. Pediatr Ann 22:675–677. https://doi.org/10.3928/0090-4481-19931101-08 CrossRefPubMed

22.

Suksamanapun N, Mauritz FA, Franken J et al (2017) Laparoscopic versus percutaneous endoscopic gastrostomy placement in children: results of a systematic review and meta-analysis. J Minim Access Surg 13:81–88. https://doi.org/10.4103/0972-9941.181776 CrossRefPubMedPubMedCentral

23.

Novotny NM, Jester AL, Ladd AP (2009) Preoperative prediction of need for fundoplication before gastrostomy tube placement in children. J Pediatr Surg 44:173–176. https://doi.org/10.1016/j.jpedsurg.2008.10.030 (discussion 176–7)CrossRefPubMed

24.

Ponsky TA, Gasior AC, Parry J et al (2013) Need for subsequent fundoplication after gastrostomy based on patient characteristics. J Surg Res 179:1–4. https://doi.org/10.1016/j.jss.2012.03.064 CrossRefPubMed

25.

Barnhart DC, Hall M, Mahant S et al (2013) Effectiveness of fundoplication at the time of gastrostomy in infants with neurological impairment. JAMA Pediatr 167:911–918. https://doi.org/10.1001/jamapediatrics.2013.334 CrossRefPubMed

26.

Razeghi S, Lang T, Behrens R (2002) Influence of percutaneous endoscopic gastrostomy on gastroesophageal reflux: a prospective study in 68 children. J Pediatr Gastroenterol Nutr 35:27–30CrossRefPubMed

27.

Toporowska-Kowalska E, Gębora-Kowalska B, Jabłoński J et al (2011) Influence of percutaneous endoscopic gastrostomy on gastro-oesophageal reflux evaluated by multiple intraluminal impedance in children with neurological impairment. Dev Med Child Neurol 53:938–943. https://doi.org/10.1111/j.1469-8749.2011.04031.x CrossRefPubMed

28.

Thomson M, Rao P, Rawat D, Wenzl TG (2011) Percutaneous endoscopic gastrostomy and gastro-oesophageal reflux in neurologically impaired children. World J Gastroenterol 17:191–196. https://doi.org/10.3748/wjg.v17.i2.191 CrossRefPubMedPubMedCentral

29.

Vande Velde S, Van Biervliet S, De Bruyne R et al (2010) Gastric dysmotility following orthopaedic scoliosis surgery in patients with cerebral palsy: a case series. Neuropediatrics 41:182–185. https://doi.org/10.1055/s-0030-1265227 CrossRefPubMed

30.

Ellis FH (1992) The Nissen fundoplication. Ann Thorac Surg 54:1231–1235CrossRefPubMed

31.

Nissen R (1937) Die transpleurale Resektion der Kardia. Dtsch Z Chir 249:311–316. https://doi.org/10.1007/BF02801116 CrossRef

32.

Nissen R (1956) A simple operation for control of reflux esophagitis. Schweiz Med Wochenschr 86:590–592PubMed

33.

Katkhouda N, Khalil MR, Manhas S et al (2002) André Toupet: surgeon technician par excellence. Ann Surg 235:591–599CrossRefPubMedPubMedCentral

34.

Thal AP (1968) A unified approach to surgical problems of the esophagogastric junction. Ann Surg 168:542–550CrossRefPubMedPubMedCentral

35.

Ashcraft KW, Holder TM, Amoury RA et al (1984) The Thal fundoplication for gastroesophageal reflux. J Pediatr Surg 19:480–483CrossRefPubMed

36.

Glen P, Chassé M, Doyle M‑A et al (2014) Partial versus complete fundoplication for the correction of pediatric GERD: a systematic review and meta-analysis. PLoS ONE 9:e112417. https://doi.org/10.1371/journal.pone.0112417 CrossRefPubMedPubMedCentral

37.

Lacher M, Kuebler JF, Dingemann J, Ure BM (2014) Minimal invasive surgery in the newborn: current status and evidence. Semin Pediatr Surg 23:249–256. https://doi.org/10.1053/j.sempedsurg.2014.09.004 CrossRefPubMed

38.

Feng X, Morandi A, Boehne M et al (2015) 3‑Dimensional (3D) laparoscopy improves operating time in small spaces without impact on hemodynamics and psychomental stress parameters of the surgeon. Surg Endosc 29:1231–1239. https://doi.org/10.1007/s00464-015-4083-3 CrossRefPubMed

39.

Rhee D, Zhang Y, Chang DC et al (2011) Population-based comparison of open vs laparoscopic esophagogastric fundoplication in children: application of the Agency for Healthcare Research and Quality pediatric quality indicators. J Pediatr Surg 46:648–654. https://doi.org/10.1016/j.jpedsurg.2010.09.012 CrossRefPubMed

40.

Ostlie DJ, Peter StSD, Snyder CL et al (2007) A financial analysis of pediatric laparoscopic versus open fundoplication. J Laparoendosc Adv Surg Tech A 17:493–496. https://doi.org/10.1089/lap.2006.0064 CrossRefPubMed

41.

Fox D, Morrato E, Campagna EJ et al (2011) Outcomes of laparoscopic versus open fundoplication in children’s hospitals: 2005–2008. Pediatr Electron Pages 127:872–880. https://doi.org/10.1542/peds.2010-1198 CrossRef

42.

Muensterer OJ (2013) Gastroösophagealer Reflux bei Kindern und Jugendlichen. Kinderchirurgie. https://doi.org/10.1007/978-3-662-53390-1_40-1 CrossRef

43.

Fyhn TJ, Knatten CK, Edwin B et al (2015) Randomized controlled trial of laparoscopic and open Nissen fundoplication in children. Ann Surg 261:1061–1067. https://doi.org/10.1097/SLA.0000000000001045 CrossRefPubMed

44.

McHoney M, Wade AM, Eaton S et al (2011) Clinical outcome of a randomized controlled blinded trial of open versus laparoscopic Nissen fundoplication in infants and children. Ann Surg 254:209–216. https://doi.org/10.1097/SLA.0b013e318226727f CrossRefPubMed

45.

Ru W, Wu P, Feng S et al (2016) Laparoscopic versus open Nissen fundoplication in children: a systematic review and meta-analysis. J Pediatr Surg 51:1731–1736. https://doi.org/10.1016/j.jpedsurg.2016.07.012 CrossRefPubMed

46.

Horwood JF, Calvert W, Mullassery D et al (2015) Simple fundoplication versus additional vagotomy and pyloroplasty in neurologically impaired children—a single centre experience. J Pediatr Surg 50:275–279. https://doi.org/10.1016/j.jpedsurg.2014.11.011 CrossRefPubMed

47.

Alexander F, Wyllie R, Jirousek K et al (1997) Delayed gastric emptying affects outcome of Nissen fundoplication in neurologically impaired children. Surgery 122:690–697 (discussion 697–8)CrossRefPubMed

48.

DeAntonio JH, Parrish DW, Rosati SF et al (2017) Laparoscopic gastroesophageal dissociation in neurologically impaired children with gastroesophageal reflux disease. J Pediatr Surg 53:30–35. https://doi.org/10.1016/j.jpedsurg.2017.10.010 CrossRef

49.

Coletta R, Aldeiri B, Jackson R, Morabito A (2019) Total esophagogastric dissociation (TEGD): Lessons from two decades of experience. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2019.02.031 CrossRefPubMed

50.

Lansdale N, McNiff M, Morecroft J et al (2015) Long-term and “patient-reported” outcomes of total esophagogastric dissociation versus laparoscopic fundoplication for gastroesophageal reflux disease in the severely neurodisabled child. J Pediatr Surg 50:1828–1832. https://doi.org/10.1016/j.jpedsurg.2015.06.021 CrossRefPubMed

51.

Tannuri ACA, Tannuri U, Mathias AL et al (2008) Gastroesophageal reflux disease in children: efficacy of Nissen fundoplication in treating digestive and respiratory symptoms. Experience of a single center. Dis Esophagus 21:746–750. https://doi.org/10.1111/j.1442-2050.2008.00860.x CrossRefPubMed

52.

Heinrich M, Kain A, Bergmann F, von Schweinitz D (2017) Parents reported reduced symptoms and improved satisfaction after fundoplication and their perceptions were an important outcome measure. Acta Paediatr 106:168–173. https://doi.org/10.1111/apa.13621 CrossRefPubMed

53.

Rossi V, Mazzola C, Leonelli L et al (2016) Long-term outcome and need of re-operation in gastro-esophageal reflux surgery in children. Pediatr Surg Int 32:277–283. https://doi.org/10.1007/s00383-015-3853-2 CrossRefPubMed

54.

Lauriti G, Lisi G, Lelli Chiesa P et al (2018) Gastroesophageal reflux in children with neurological impairment: a systematic review and meta-analysis. Pediatr Surg Int 34:1139–1149. https://doi.org/10.1007/s00383-018-4335-0 CrossRefPubMed

55.

Mauritz FA, van Herwaarden-Lindeboom MYA, Zwaveling S et al (2014) Laparoscopic thal fundoplication in children A prospective 10- to 15-year follow-up study. Ann Surg 259:388–393. https://doi.org/10.1097/SLA.0b013e318294102e CrossRefPubMed

56.

Baerg J, Thorpe D, Gasior A et al (2015) Factors associated with mortality after Nissen fundoplication in children. Eur J Pediatr Surg 25:277–283. https://doi.org/10.1055/s-0034-1373848 CrossRefPubMed

57.

Muensterer OJ (2016) Fundoplication in infants and children. In: Till H, Thomson M, Foker J et al (Hrsg) Esophageal and gastric disorders in infancy and childhood. Springer, Berlin, Heidelberg, S 1069–1083

Titel: Anti-Reflux-Chirurgie bei mehrfach behinderten Kindern
verfasst von: PD Dr. med. J.-H. Gosemann
Prof. Dr. med. M. Lacher
Publikationsdatum: 17.07.2019
Verlag: Springer Medizin
Schlagwörter: Dysphagie
Gastroösophageale Refluxkrankheit
Dysphagie
Fundoplikatio
Antirefluxverfahren
Fundoplikatio
Gastrostomie
Antirefluxverfahren
Laparoskopie
Dysphagie
Erschienen in: Monatsschrift Kinderheilkunde / Ausgabe 8/2019
Print ISSN: 0026-9298
Elektronische ISSN: 1433-0474
DOI: https://doi.org/10.1007/s00112-019-0733-1

Magen-Darm-Erkrankungen in der Hausarztpraxis

Häufige gastrointestinale Krankheiten in der niedergelassenen Praxis sind Thema in diesem aufgezeichneten MMW-Webinar. Welche Differenzialdiagnosen bei Oberbauchbeschwerden sollten Sie kennen? Wie gelingt eine erfolgreiche probiotische Behandlung bei Reizdarm? Welche neuen Entwicklungen und praktischen Aspekte gibt es bei Diagnostik und Behandlung der chronisch entzündlichen Darmerkrankungen?

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2019

Mitteilungen der ÖGKJ

Warum schwoll dem Mädchen der schmerzende Kopf?

Rolle der Palliativmedizin in der pädiatrischen Intensivmedizin

Hot Topic Kinderchirurgie

Sicherung der Atemwege des Neugeborenen bei beidseitiger Choanalatresie

Atemwegssicherung des Neugeborenen mit beidseitiger Choanalatresie

Magen-Darm-Erkrankungen in der Hausarztpraxis