Gastric emptying scans: unnecessary preoperative testing for fundoplications?

J Pediatr Surg. 2010 Feb;45(2):350-4; discussion 354. doi: 10.1016/j.jpedsurg.2009.10.077.

Abstract

Purpose: Delayed gastric emptying (DGE) as indicated by preoperative gastric emptying scan (GES) is one rationale for performing a gastric emptying procedure (GEP) at time of fundoplication for gastroesophageal reflux disease (GERD). However, the role of GES and GEP in the surgical management of GERD remains unclear. We examined the use of preoperative GES in fundoplication patients.

Methods: Retrospective chart review of patients undergoing fundoplication from 2000 to 2005 in a single institution including patient demographics, operative procedure, and postoperative outcomes at 1-year follow-up was analyzed using chi(2) test.

Results: Of 76 fundoplication patients, 39 (51%) had preoperative GES with 11 patients (28%) having DGE and 16 GEP performed. Developmentally delayed children were more likely to have GES. There were no significant differences in postoperative complications, length of hospital stay, or use of anti-GERD medications at 1 year between patients who had preoperative GES and those who did not. In the developmentally delayed group, there were no differences in outcomes between those with preoperative GES and those who did not.

Conclusions: There were no differences in outcomes for GERD patients with or without preoperative GES or GEP postfundoplication. The use of GES in the management of GERD requires further evaluation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Comorbidity
  • Developmental Disabilities / epidemiology
  • Female
  • Follow-Up Studies
  • Fundoplication / methods*
  • Gastric Emptying / physiology*
  • Gastroesophageal Reflux / diagnostic imaging
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Preoperative Care / methods*
  • Radionuclide Imaging / methods
  • Retrospective Studies
  • Stomach / diagnostic imaging*
  • Treatment Outcome