Laparoscopic versus traditional fundoplication in the treatment of children with refractory gastro-oesophageal reflux

Abstract

Background/aims: A retrospective study has been carried out on the last 20 consecutive patients operated for gastro-oesophageal reflux to compare the results of the traditional operation with those using the laparoscopic approach.

Methods: In ten cases, the operation was performed with an open traditional approach and in the other 10 cases using laparoscopy. The mean age of the patients was 7 years and their mean weight was 20 kg. There were 11 girls and 9 boys. We used a 360 degrees Nissen fundoplication in the patients operated on via laparotomy and a Nissen-Rossetti fundoplication in patients operated on via laparoscopy.

Results: Mean operating time was 65 minutes for traditional surgery and 100 minutes for laparoscopy. There were two complications: 1 case of oesophageal perforation in a child affected by endo-brachyoesophagus with peri-oesophagitis, operated using the laparoscopic technique, and one case of wound infection in a child operated with the open technique. The hospital stay was remarkably shorter and less painful for the children operated on laparoscopically. At 13-month mean follow-up, all 20 patients are alive and present no reflux symptoms.

Conclusions: Our results demonstrate that laparoscopic surgery is a valid alternative to the traditional surgical approach for the treatment of gastro-oesophageal reflux.