Erschienen in:
01.10.2005 | Original article
European multicenter survey on the laparoscopic treatment of gastroesophageal reflux in patients aged less than 12 months with supraesophageal symptoms
verfasst von:
G. Mattioli, K. Bax, F. Becmeur, C. Esposito, Y. Heloury, G. Podevin, M. Lima, G. A. MacKinlay, A. Goessler, J. A. Tovar, J. Valla, P. Tuo, L. Nahum, G. Ottonello, O. Sacco, V. Gentilino, A. Pini-Prato, E. Caponcelli, V. Jasonni
Erschienen in:
Surgical Endoscopy
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Ausgabe 10/2005
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Abstract
Background:
This multicenter survey includes neonates and infants who underwent surgery for primary gastroesophageal reflux (GER) who presented with supraesophageal symptoms of unknown origin with a minimum of 12 months postoperative follow-up.
Methods:
A total of 726 patients underwent GER surgery in 10 European Centers in the period 1998–2002. Respiratory symptoms were present in 204 patients (28%); 135 patients (17%) had surgery under 1 year of age, and 46 of them (6.3%) because of respiratory symptoms. Surgery was performed without any previous medical treatment in 10 cases (21%). The type of procedure included 37 complete 360° wraps (80%) (Nissen, 12, and Rossetti, 25) and nine partial wraps (20%) (Thal five, Lortat Jacob one, Toupet one, others two). Gastrostomy was associated in 17 cases (37%) (6 PEG and 11 modified Stamm). No gastric emptying procedures were recorded.
Results:
No major intraoperative complications were reported. Six patients developed complications (13%) and a redo operation was performed in three (6.5%). Respiratory outcome after antireflux surgery was good in 35 patients (76%) and fair with significantly improved respiratory symptoms in 11 (24%).
Conclusions:
This multicenter survey underlines that GER has to be suspected and aggressively treated in infants with difficult-to-treat supraesophageal symptoms, and also in high-risk cases, in order to prevent major complications.