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European Surgery
Published in: European Surgery 1/2023

Open Access 29-09-2022 | Antireflux Surgery | original article

Impact of previous abdominal surgery on the outcome of fundoplication for medically refractory gastroesophageal reflux disease in children and young adults

Authors: Franziska Christiane Steffens, Dr. med. Marcus Dahlheim, Prof. Dr. med. Patrick Günther, Prof. Dr. med. Arianeb Mehrabi, PD Dr. med. Raphael N. Vuille-Dit-Bille, Dr. med. Ulrich Klaus Fetzner, Prof. Dr. med. Berthold Gerdes, PD Dr. med. Giovanni Frongia

Published in: European Surgery | Issue 1/2023

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Summary

Importance

Fundoplication (FP) is a well-established surgical treatment for gastroesophageal reflux disease (GERD) refractory to medical therapy in children and young adults. During FP, previous abdominal surgery (PAS) can impair the patient’s outcome by causing technical difficulties and increasing intra- and postoperative complication rates.

Objective

The aim of this study was to determine the impact of PAS on the short- and long-term outcome following FP for refractory GERD in a cohort of patients aged < 23 years.

Methods

We retrospectively analyzed 182 patients undergoing a total of 201 FP procedures performed at our university center for pediatric surgery from February 1999 to October 2019. Pre-, intra-, and postoperative variables were recorded and their impact on the rate of intraoperative complications and revision FP (reFP) was analyzed.

Results

A total of 201 FP procedures were performed on 182 patients: 119 (59.2%) as Thal-FP (180° anterior wrap) and 82 (40.8%) as Nissen-FP (360°circular wrap; 67.2% laparoscopic, 32.8% open, 8.9% conversion). The presence of PAS (95 cases, 47.3%) was associated with significantly longer operative times for FP (153.4 ± 53.7 vs.126.1 ± 56.4 min, p = 0.001) and significantly longer hospital stays (10.0 ± 7.0 vs. 7.0 ± 4.0 days, p < 0.001), while the rates of intraoperative surgical complications (1.1% vs. 1.9%, p = 1.000) and the rate re-FP in the long term (8.4% vs. 15.1%, p = 0.19) during a follow-up period of 53.4 ± 44.5 months were comparable to the group without PAS.

Conclusion

In cases of PAS in children and young adults, FP for refractory GERD might necessitate longer operative times and longer hospital stays but can be performed with surgery-related short- and long-term complication rates comparable to cases without PAS.
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Metadata
Title
Impact of previous abdominal surgery on the outcome of fundoplication for medically refractory gastroesophageal reflux disease in children and young adults
Authors
Franziska Christiane Steffens
Dr. med. Marcus Dahlheim
Prof. Dr. med. Patrick Günther
Prof. Dr. med. Arianeb Mehrabi
PD Dr. med. Raphael N. Vuille-Dit-Bille
Dr. med. Ulrich Klaus Fetzner
Prof. Dr. med. Berthold Gerdes
PD Dr. med. Giovanni Frongia
Publication date
29-09-2022
Publisher
Springer Vienna
Published in
European Surgery / Issue 1/2023
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-022-00775-7

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