Postoperative Lower Esophageal Dilation in Children Following the Performance of Nissen Fundoplication

Anne Schneider; Frédéric Gottrand; Rony Sfeir; Alain Duhamel; Michel Bonnevalle; Dominique Guimber; Laurent Michaud

doi:10.1055/s-0032-1315807

European Journal of Pediatric Surgery, Inhaltsverzeichnis

Eur J Pediatr Surg 2012; 22(05): 399-403
DOI: 10.1055/s-0032-1315807

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Postoperative Lower Esophageal Dilation in Children Following the Performance of Nissen Fundoplication

Anne Schneider

¹Department of Pediatric Surgery, University Hospital of Strasbourg, Strasbourg, France

,

Frédéric Gottrand

²Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

,

Rony Sfeir

³Department of Pediatric Surgery, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

,

Alain Duhamel

⁴Department of Biostatistics, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

,

Michel Bonnevalle

³Department of Pediatric Surgery, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

,

Dominique Guimber

²Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

,

Laurent Michaud

²Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France

› Institutsangaben

Abstract

Objectives The purpose of this study is to study the frequency and factors associated with lower esophageal dilation (LED) after Nissen fundoplication.

Methods This retrospective monocentric study included 288 patients who had undergone Nissen fundoplication from 1998 to 2009. The frequency of children requiring LED was assessed. The clinical characteristics of the patients at the time of fundoplication, their symptoms, and outcomes were recorded. The population with LED (group 1) was compared with the population without LED (group 2) to identify factors associated with postfundoplication LED using multivariate analysis.

Results LED was required by 70 patients (24%) because of postoperative dysphagia, and 45/70 were dilated within the first 6 months. The mean age at dilation was 72 months (standard deviation [SD] 65), with an average post-Nissen delay of 9 months (SD 13). Surgical revision was required by 11 patients because of LED failure (n = 10) or postdilation perforation (n = 1). Patients who required post-Nissen dilation were significantly more frequently fed orally than those in group 2 and had more postoperative complications (dumping syndrome, surgical revision).

Conclusions A significant frequency of postfundoplication LED was observed in this pediatric population. Dilation was associated in children with preoperative feeding or postoperative complications (dumping syndrome, surgical revision).

Keywords

Nissen fundoplication - lower esophageal dilation - persistent dysphagia

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Referenzen

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