Laparoscopic vs open approach for the treatment of gastroesophageal reflux in children

  • Mattioli G
  • Repetto P
  • Carlini C
 et al. 
  • 6

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Abstract

The laparoscopic approach has, become increasingly popular for fundoplication over the last few years; however many surgeons are skeptical about its real advantages. Methods: We conducted a prospective comparative study of children operated on for gastroesophageal reflux (GER). Exclusion criteria included age < 1 year and > 14 years, previous surgery on the esophagus or stomach, and neurologic impairment. We compared two groups of patients who met the same inclusion/exclusion criteria. One group was treated via a laparotomic approach between January 1993 and December 1997; the other was treated via a laparoscopic approach between September 1998 and December 2000. A 360° wrap was performed in each group. Results: Group I (laparotomic approach) included 17 patients; mean operative time was 100 min and postoperative time was 7 days. Group 2 comprised 49 children operated on via a laparoscopic approach; mean operative time was 78 min and postoperative time was 48 hours. No major complications were encountered in either group. In postoperative period, two patients in group 1 had complications. One had a prolonged bout of gastroplegia, which required nasogastric drainage, and then recovered spontaneously after 20 days; the other had stenosis of the wrap, which required dilation. No relapses occurred during a follow-up of 6 months. Long-term follow-up data are not presented. Comparative analysis of the short-term functional results indicated that there were no differences between the two groups. Conclusion: This study confirms that the minimally invasive approach is safe and effective for the treatment of primary gastroesophageal reflux disease in children.

Author-supplied keywords

  • article
  • clinical article
  • gastroesophageal reflux
  • human
  • laparoscopic surgery
  • preschool child
  • priority journal
  • stomach fundoplication
  • surgical approach
  • surgical technique
  • treatment outcome

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Authors

  • G Mattioli

  • P Repetto

  • C Carlini

  • M Torre

  • A PiniPrato

  • C Mazzola

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