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Nascer e Crescer
versão impressa ISSN 0872-0754
Resumo
MOREIRA-PINTO, João et al. Recurrence of gastroesophageal reflux after fundoplication in a paediatric population. Nascer e Crescer [online]. 2012, vol.21, n.3, pp.131-134. ISSN 0872-0754.
Introduction and aim: Nissen fundoplication is the standard treatment of hiatal hernia repair and treatment of gastroesophageal reflux resistant to medical therapy. Recurrence of the disease (rGER) is a common problem. The aim of this study was to understand in which patients rGER will most probably appear and why. Material and methods: Retrospective analysis of the charts of patients submitted to Nissen fundoplication between February 2000 and March 2009 in our Hospital. Patients were divided in: rGER group and control group (without rGER). We compared both groups, concerning gender, age, and weight at the time of surgery, diagnosis of hiatal hernia, other comorbidities, presence of severe neurological failure, frequent seizures, chronic pulmonary medication, O2 supplementation, and/or chronic antibiotherapy pre-operatively, surgical technique (open or laparoscopic), gastrostomy tube placement, using exact Fischer’s test. Results: 65 patients were submitted to Nissen fundiplication. Ten patients were included in the rGER group (15,4%). After analyzing the above parameters, we found only find statistical significance for gastrostomy tube placement previous or simultaneously to the fundoplication (50% in rGER group versus 13% in control group, p=0,015). Conclusions: In our study, rGER was higher in patients in whom a gastrostomy tube was placed previous or simultaneously. This could be an indirect sign of a worse neurological impair, although no statically difference was found in the other parameters. Further studies with more cases will be necessary for more reliable conclusions.
Palavras-chave : Adolescent; child; gastroesophageal reflux; gastrostomy; hiatal hernia; mentally disabled persons; recurrence.