Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Dec;74(6):1881-1887.
doi: 10.1007/s13304-022-01384-5. Epub 2022 Sep 21.

Total esophagogastric dissociation (TEGD) in neurologically impaired children: the floor to parents

Giovanni Parente  1 , Sara Maria Cravano #  2 , Marco Di Mitri #  2 , Eduje Thomas  2 , Chiara Girella  2 , Simone D'Antonio  2 , Tommaso Gargano  2 , Mario Lima  2
Affiliations
Observational Study

Total esophagogastric dissociation (TEGD) in neurologically impaired children: the floor to parents

Giovanni Parente et al. Updates Surg. 2022 Dec.

Abstract

Total esophagogastric dissociation (TEGD) was proposed to treat gastroesophageal reflux disease (GERD) both as a rescue in case of fundoplication failure and as first-line surgery in neurologically impaired children (NIC). Aim of the study is to evaluate the impact of TEGD on the quality of life (QoL) of both NIC and their caregivers focusing on the parents' point of view. A retrospective observational study was conducted on all NIC who underwent TEGD in our center between 2012 and 2022. A questionnaire centered on the parents' point of view and investigating QoL of NIC and their caregivers was administered to all patients' parents. Data were compared using Fisher exact test and Mann-Whitney test; a p-value < 0.05 was considered statistically significant. 12 patients were enrolled in the study. Parents reported improvements in weight gain (p = 0.03), sleep disorders, apnea, regurgitation and vomiting (p < 0.01). Caregivers also declared a decrease in number of hospitalizations, particularly related to severe respiratory infections and ab ingestis pneumonia (p = 0.01). We also documented a reduction of caregivers' worries during food administration (p < 0.01). 50% of parents whose children were subjected to both fundoplication and TEGD would suggest TEGD as first line surgical treatment instead of fundoplication. According to parents' point of view, TEGD improves significantly NIC QoL and 50% of them would enthusiastically suggest TEGD as first-line surgical approach to GERD in NIC.

Keywords: Abdominal surgery; Fundoplication; GERD; Neurologically impaired children; QoL; TEGD; Total esophagogastric dissociation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Questionnaire administered to patients' caregivers
Fig. 2
Fig. 2
Open TEGD (for details, please read the "surgical procedure" section of methods)
Fig. 3
Fig. 3
Results of TEGD on the main outcomes investigated. Chart shows the median of the answers before and after surgery (1 = never, 2 = almost never, 3 = sometimes, 4 = often, 5 = almost always)
Fig. 4
Fig. 4
Mean time required for feeding before and after TEGD
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lansdale N, McNiff M, Morecroft J, Kauffmann L, Morabito A. Long-term and 'patient-reported' outcomes of total esophagogastric dissociation versus laparoscopic fundoplication for gastroesophageal reflux disease in the severely neurodisabled child. J Pediatr Surg. 2015;50(11):1828–1832. doi: 10.1016/j.jpedsurg.2015.06.021. - DOI - PubMed
    1. Lopez-Fernandez S, Hernandez F, Hernandez-Martin S, et al. Failed Nissen fundoplication in children: causes and management. Eur J Pediatr Surg. 2014;24(1):79–82. doi: 10.1055/s-0033-1351664. - DOI - PubMed
    1. Ceriati E, Marchetti P, Caccamo R, Adorisio O, Rivosecchi F, De Peppo F. Nissen fundoplication and combined procedures to reduce recurrence of gastroesophageal reflux disease in neurologically impaired children. Sci Rep. 2020;10(1):11618. doi: 10.1038/s41598-020-68595-x. - DOI - PMC - PubMed
    1. Banerjee DB, Parekh P, Cross K, et al. Long-term outcomes following failure of Nissen fundoplication. Pediatr Surg Int. 2022 doi: 10.1007/s00383-022-05098-y. - DOI - PubMed
    1. Bianchi A. Total esophagogastric dissociation: an alternative approach. J Pediatr Surg. 1997;32(9):1291–1294. doi: 10.1016/s0022-3468(97)90304-3. - DOI - PubMed

Publication types