Title

Fever after redo Nissen fundoplication with hiatal hernia repair.

Document Type

Article

Publication Date

8-1-2014

Identifier

PMID: 24948540 DOI: 10.1016/j.jss.2014.05.021

Abstract

BACKGROUND: Fevers often arise after redo fundoplication with hiatal hernia repair. We reviewed our experience to evaluate the yield of a fever work-up in this population.

METHODS: We performed a retrospective review of children undergoing redo Nissen fundoplication with hiatal hernia repair between December 2001 and September 2012. Temperatures and fever evaluations of those children receiving a mesh repair were compared with those without mesh. A fever defined as temperature ≥38.4°C.

RESULTS: Fifty one children received 46 laparoscopic, 4 open, and 1 laparoscopic converted to open procedures. Biosynthetic mesh was used in 25 children whereas 26 underwent repair without mesh. A fever occurred in 56% of those repaired with mesh compared with 23.1% without mesh (P = 0.02). A fever evaluation was conducted in 32% of those with mesh compared with 11.5% without mesh (P = 0.52). A urinary tract infection was identified in one child after mesh use and an infection was identified in two children without mesh, one pneumonia and one wound infection (P = 1). In those repaired with mesh, there was no significant difference in maximum temperature.

CONCLUSIONS: Fever is common after redo Nissen fundoplication with hiatal hernia repair and occurs more frequently, and with higher temperatures in those with mesh. Fever work-up in these patients is unlikely to yield an infectious source and is attributed to the extensive dissection during the redo procedure.

Journal Title

The Journal of surgical research

Volume

190

Issue

2

First Page

594

Last Page

597

MeSH Keywords

Child; Child, Preschool; Fever; Fundoplication; Hernia, Hiatal; Humans; Infant; Postoperative Complications; Reoperation; Retrospective Studies

Keywords

Nissen surgery

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