Risk factors for recurrent reflux in children after laparoscopic fundoplication - A 10-year follow-up analysis [Oral presentation]

Abstract

<p><b>Purpose:</b> To report the long-term outcomes of children who have undergone laparoscopic fundoplication (LF) for gastro-esophageal reflux disease (GERD) and analyze factors leading to recurrent GERD.</p><p><span><b>Materials and Methods: </b></span><span>This was a retrospective single-centerd study. Paediatric patients who underwent LF for GERD between 2004 to 2014 were reviewed. The outcomes were recurrence of GERD symptoms, the need of anti-acid treatment and further anti-reflux procedures. Risk factors for recurrence were evaluated by regression analysis.</span></p><p><b>Results: </b>Sixty-four patients were included and 51 patients (79.7%) were neurologically impaired. Gastrostomy was performed in 58 patients (90.1%) during the same session. The median age at LF was 64.5 months (range: 2.6 to 228 months) and the median body weight was 21.3 kg (range: 3.6 to 64.5kg). The was no 30-day mortality and 30-day morbidities (Grade III or above) was 12.5% (n=8). At a median follow up period of 15.8 years (range: 10.5 to 19 years), 9 patients (14.0%) developed recurrent GERD symptoms confirmed with either pH study or contrast study. Eight patients (12.5%) required anti-acid treatment and 4 patients (6.25%) required further procedure (re-do LF = 2; insertion of gastrojejunostomy tube feeding = 2) at a median period of 26 months after LF (range 14.5 to 36.0 months) . Regression analysis revealed that LF performed at the age after 5 year-old was a risk factor for recurrence.</p><p><b>Conclusion: </b>The majority of children with LF for GERD could remain symptom-free after 10 years. LF performed at a younger age was associated with a lower risk of recurrence.</p>