Premium
Comparison of laparoscopic Toupet and laparoscopic Nissen fundoplications in neurologically normal children
Author(s) -
Miyano Go,
Yamoto Masaya,
Miyake Hiromu,
Kaneshiro Masakatsu,
Morita Keiichi,
Nouso Hiroshi,
Koyama Mariko,
Okawada Manabu,
Doi Takashi,
Koga Hiroyuki,
Lane Geoffrey J,
Fukumoto Koji,
Yamataka Atsuyuki,
Urushihara Naoto
Publication year - 2018
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12430
Subject(s) - medicine , nissen fundoplication , surgery , laparoscopic surgery , stenosis , laparoscopy , anesthesia , gastroenterology , reflux , disease
Abstract Introduction We compared laparoscopic Toupet fundoplication (LTF) and laparoscopic Nissen fundoplication (LNF) in neurologically normal children. Methods Forty neurologically normal children who were followed up for more than 3 years after LTF ( n = 22) or LNF ( n = 18) were reviewed retrospectively. LTF and LNF were performed between 2006 and 2012. Results There were no significant differences in gender (LTF, 15 male and 7 female patients; LNF:, 12 male and 6 female patients), mean age at surgery (LTF vs LNF: 2.5 vs 2.3 years), mean weight at surgery (LTF vs LNF: 9.6 vs 8.9 kg), preoperative symptoms, preoperative pH monitoring (pH <4) (LTF vs LNF: 26.7% vs 21.8%), mean operative time (LTF vs LNF: 117 vs 126 min), postoperative recommencement of enteral feeding (LTF vs LNF: 3.7 vs 3.8 days), or duration of hospitalization (LTF vs LNF: 5.5 vs 6.3 days). Intraoperative complications were esophageal trauma (LTF; n = 1; 4.5%) and liver trauma (LNF; n = 1; 5.6%) ( P = 0.70). Post‐LTF complications were wrap stenosis ( n = 1; 4.5%), and post‐LNF complications were wrap stenosis ( n = 1; 5.5%) and gastric outlet obstruction ( n = 1; 5.5%) ( P = 0.43); all were managed conservatively. No case required conversion to open repair. There was no recurrence after LTF, but there were three cases (16.7%) after LNF ( P = 0.08). Reoperation was performed at 4, 11, and 13 months, respectively. Conclusion Despite LTF and LNF appearing to be equally effective, three LNF cases required reoperation.