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 language | English (US) |
|---|---|
| Pages (from-to) | 1169-1173 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 25 |
| Issue number | 11 |
| DOIs | |
| State | Published - Jan 1 1990 |
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Keywords
- Gastroesophageal reflux
- surgical procedures
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery
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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 journal › Article
TY - JOUR
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.
KW - Gastroesophageal reflux
KW - surgical procedures
UR - http://www.scopus.com/inward/record.url?scp=0025088813&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025088813&partnerID=8YFLogxK
U2 - 10.1016/0022-3468(90)90756-Y
DO - 10.1016/0022-3468(90)90756-Y
M3 - Article
C2 - 2273433
AN - SCOPUS:0025088813
VL - 25
SP - 1169
EP - 1173
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 11
ER -