Resumen

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.

Palabras clave : Adolescent; child; gastroesophageal reflux; gas­trostomy; hiatal hernia; mentally disabled persons; recurrence.

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