Title

A multicenter study of the incidence and factors associated with redo Nissen fundoplication in children.

Document Type

Article

Publication Date

6-1-2013

Identifier

DOI: 10.1016/j.jpedsurg.2013.03.028

Abstract

AIM: The objective of this study was to identify the incidence and factors associated with redo Nissen fundoplication in children.

METHODS: After Institutional Review Board approval (5100277), data for children under 18 years of age from two children's hospitals with fundoplication performed between January 1994 and December 2010 were reviewed. Children with one fundoplication were compared to those with redos to identify factors associated with redo. Variables were compared using t-tests for continuous and chi-square tests for categorical variables. Logistic regression evaluated for independence.

RESULTS: There were 823 patients and 54.7% were male. A redo fundoplication was required in 100 (12.2% of cohort); 82 had 1 redo, 14 had 2 redos, and 4 had 3 redos. Follow-up ranged from 0.01 to 16.9 years (median: 2.9 years). Factors associated with redo were: younger age at first fundoplication, (p=0.002), hiatal dissection (p

CONCLUSION: The incidence of redo fundoplication in children is 12.2%. The risk of redo is significantly increased if patients are younger, have retching, and if the esophageal hiatus is dissected at the first fundoplication.

Journal Title

Journal of pediatric surgery

Volume

48

Issue

6

First Page

1306

Last Page

1311

MeSH Keywords

Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Fundoplication; Gastroesophageal Reflux; Humans; Infant; Infant, Newborn; Laparoscopy; Logistic Models; Male; Reoperation; Retrospective Studies; Risk; Treatment Failure

Keywords

Pediatric gastroesophageal reflux disease; Redo Nissen fundoplication; GERD

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