Laparoscopic redo nissen fundoplication after previous open antireflux surgery in infants and children

J Laparoendosc Adv Surg Tech A. 2014 May;24(5):359-61. doi: 10.1089/lap.2013.0464. Epub 2014 Jan 11.

Abstract

Recurrent gastroesophageal reflux is a common complication after fundoplication procedures. We report our experience with laparoscopic redo Nissen fundoplications in pediatric patients with a history of open antireflux procedure. The medical records of all patients with a history of open antireflux procedure who underwent a subsequent laparoscopic redo Nissen fundoplication were reviewed. One hundred eighty laparoscopic Nissen fundoplications were performed between September 2004 and September 2012; 23 were redo procedures. Twelve patients had a history of prior open fundoplication. Average time between operations was 113.7±64 months. Seven patients presented with emesis, 4 with aspiration pneumonia, and 1 with clinical reflux. Eight had a history of cerebral palsy and/or seizure disorder. Laparoscopic revision was completed in 100% of the patients, with no intraoperative complications. Average operative time was 177.5±86 minutes. Seven patients were able to resume feeds on postoperative Day 1. Median length of stay was 3 days. Median follow-up was 21 months. One patient required a redo antireflux procedure 8 months later for persistent dysphagia. Thus laparoscopic revision Nissen fundoplication after a prior open antireflux procedure is feasible and safe.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Esophagus / surgery
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Fundoplication / methods*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnostic imaging
  • Gastroesophageal Reflux / surgery*
  • Hernia, Hiatal / complications
  • Hernia, Hiatal / diagnostic imaging
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Operative Time
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Young Adult