Around half of pediatric patients undergoing fundoplication have neurological impairment (NI) with diagnoses such as cerebral palsy and various syndromes. There are fundamental differences between children and adults undergoing anti-reflux surgery that may affect outcomes in unexpected ways. A meta-analysis combining the results from these three RCTs reported higher recurrence rates and longer operation time after LF, but similar length of hospital stay and complication rates. In children, only three RCTs including a total of 171 patients, have compared outcomes after LF and OF. Pediatric surgeons have assumed that LF has the same benefits in children as in adults, and several non-randomized studies have shown better outcome after LF. Consequently, LF has replaced OF as the surgical treatment of choice for adult GERD. Furthermore, these RCTs found no differences in recurrence rates of gastroesophageal disease (GERD) or patient satisfaction, even 10 to 15 years postoperatively. Multiple randomized controlled trials (RCT) have shown that adults undergoing laparoscopic fundoplication (LF) have shorter convalescence, fewer complications, and better cosmetic results than those operated with open fundoplication (OF). Patient/parental satisfaction with outcome was high, independent of surgical approach (LF: 81%, OF: 88%, p = 0.500). Overall opinion of the surgical scars was good in both groups (LF: 95%, OF: 86%, p = 0.610). Regurgitation/vomiting were observed in 6% after LF and 3% after OF ( p = 0.609), and heartburn in 14% after LF and 17% after OF ( p = 1.000). Among these, use of anti-secretory drugs was significantly decreased from preoperatively after both LF (94% vs. Seventy patients/parents were interviewed median 11.9 years postoperatively. Eight (19%) underwent redo fundoplication after LF and three (7%) after OF ( p = 0.094). Median time to recurrence was 1.0 and 5.1 years after LF and OF, respectively. Three were lost to follow-up before first scheduled control. Meine Inhalte subNavigationMarker subNavigationPointerĮighty-eight children, 56 (64%) boys, were randomized (LF 44, OF 44) at median 4.4 years.
![download ibm spss statistics 19 trial version download ibm spss statistics 19 trial version](https://image.slidesharecdn.com/ibmspssstatisticsbase19-140519154252-phpapp02/95/ibm-spss-statistics-base-19-30-638.jpg)
Mehr subNavigationMarker subNavigationPointer.Gebiete subNavigationMarker subNavigationPointer.