Complications of gastroesophageal antireflux surgery in neurologically impaired versus neurologically normal children

R. H. Pearl*, D. K. Robie, S. H. Ein, B. Shandling, D. E. Wesson, R. Superina, K. Mctaggart, V. F. Garcia, J. A. O'Connor, R. M. Filler

*Corresponding author for this work

Research output: Contribution to journalArticle

191 Citations (Scopus)

Abstract

Antireflux surgery was performed in 234 children over a 5-year period; 153 were neurologically impaired (NI) and 81 were neurologically normal (NN). Initial presentation, demographic data, and type of antireflux operation were similar in the two groups. Eighty-six percent of the NI group versus 30% of the NN group had gastrostomy tubes placed. The incidence of late postoperative complications was 26% in the NI group and 12% in the NN group (P < .01). During the late postoperative period, NI children underwent reoperation four times as frequently as NN children (19% v 5%, respectively; P < .01). Wrap herniation accounted for 38% of complications and 59% of reoperations in the late postoperative period. Mortality due to aspiration occurred in 9% of the NI group versus 1% of the NN group. Combined failure rate (reoperation plus aspiration-induced deaths) was 28% in NI and 6% in NN (P < .01). We conclude that neurological status is the major predictor of operative success and that wrap herniation due to crural disruption is the most common cause of operative failure.

Original languageEnglish (US)
Pages (from-to)1169-1173
Number of pages5
JournalJournal of Pediatric Surgery
Volume25
Issue number11
DOIs
StatePublished - Jan 1 1990

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Reoperation
Postoperative Period
Gastrostomy
Leg
Demography
Mortality
Incidence

Keywords

  • Gastroesophageal reflux
  • surgical procedures

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Pearl, R. H. ; Robie, D. K. ; Ein, S. H. ; Shandling, B. ; Wesson, D. E. ; Superina, R. ; Mctaggart, K. ; Garcia, V. F. ; O'Connor, J. A. ; Filler, R. M. / Complications of gastroesophageal antireflux surgery in neurologically impaired versus neurologically normal children. In: Journal of Pediatric Surgery. 1990 ; Vol. 25, No. 11. pp. 1169-1173.
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abstract = "Antireflux surgery was performed in 234 children over a 5-year period; 153 were neurologically impaired (NI) and 81 were neurologically normal (NN). Initial presentation, demographic data, and type of antireflux operation were similar in the two groups. Eighty-six percent of the NI group versus 30{\%} of the NN group had gastrostomy tubes placed. The incidence of late postoperative complications was 26{\%} in the NI group and 12{\%} in the NN group (P < .01). During the late postoperative period, NI children underwent reoperation four times as frequently as NN children (19{\%} v 5{\%}, respectively; P < .01). Wrap herniation accounted for 38{\%} of complications and 59{\%} of reoperations in the late postoperative period. Mortality due to aspiration occurred in 9{\%} of the NI group versus 1{\%} of the NN group. Combined failure rate (reoperation plus aspiration-induced deaths) was 28{\%} in NI and 6{\%} in NN (P < .01). We conclude that neurological status is the major predictor of operative success and that wrap herniation due to crural disruption is the most common cause of operative failure.",
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Pearl, RH, Robie, DK, Ein, SH, Shandling, B, Wesson, DE, Superina, R, Mctaggart, K, Garcia, VF, O'Connor, JA & Filler, RM 1990, 'Complications of gastroesophageal antireflux surgery in neurologically impaired versus neurologically normal children', Journal of Pediatric Surgery, vol. 25, no. 11, pp. 1169-1173. https://doi.org/10.1016/0022-3468(90)90756-Y

Complications of gastroesophageal antireflux surgery in neurologically impaired versus neurologically normal children. / Pearl, R. H.; Robie, D. K.; Ein, S. H.; Shandling, B.; Wesson, D. E.; Superina, R.; Mctaggart, K.; Garcia, V. F.; O'Connor, J. A.; Filler, R. M.

In: Journal of Pediatric Surgery, Vol. 25, No. 11, 01.01.1990, p. 1169-1173.

Research output: Contribution to journalArticle

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T1 - Complications of gastroesophageal antireflux surgery in neurologically impaired versus neurologically normal children

AU - Pearl, R. H.

AU - Robie, D. K.

AU - Ein, S. H.

AU - Shandling, B.

AU - Wesson, D. E.

AU - Superina, R.

AU - Mctaggart, K.

AU - Garcia, V. F.

AU - O'Connor, J. A.

AU - Filler, R. M.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - Antireflux surgery was performed in 234 children over a 5-year period; 153 were neurologically impaired (NI) and 81 were neurologically normal (NN). Initial presentation, demographic data, and type of antireflux operation were similar in the two groups. Eighty-six percent of the NI group versus 30% of the NN group had gastrostomy tubes placed. The incidence of late postoperative complications was 26% in the NI group and 12% in the NN group (P < .01). During the late postoperative period, NI children underwent reoperation four times as frequently as NN children (19% v 5%, respectively; P < .01). Wrap herniation accounted for 38% of complications and 59% of reoperations in the late postoperative period. Mortality due to aspiration occurred in 9% of the NI group versus 1% of the NN group. Combined failure rate (reoperation plus aspiration-induced deaths) was 28% in NI and 6% in NN (P < .01). We conclude that neurological status is the major predictor of operative success and that wrap herniation due to crural disruption is the most common cause of operative failure.

AB - Antireflux surgery was performed in 234 children over a 5-year period; 153 were neurologically impaired (NI) and 81 were neurologically normal (NN). Initial presentation, demographic data, and type of antireflux operation were similar in the two groups. Eighty-six percent of the NI group versus 30% of the NN group had gastrostomy tubes placed. The incidence of late postoperative complications was 26% in the NI group and 12% in the NN group (P < .01). During the late postoperative period, NI children underwent reoperation four times as frequently as NN children (19% v 5%, respectively; P < .01). Wrap herniation accounted for 38% of complications and 59% of reoperations in the late postoperative period. Mortality due to aspiration occurred in 9% of the NI group versus 1% of the NN group. Combined failure rate (reoperation plus aspiration-induced deaths) was 28% in NI and 6% in NN (P < .01). We conclude that neurological status is the major predictor of operative success and that wrap herniation due to crural disruption is the most common cause of operative failure.

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