Long-term quantitative results following fundoplication and antroplasty for gastroesophageal reflux and delayed gastric emptying in children.
BACKGROUND
The operative management of children with combined gastroesophageal reflux and delayed gastric emptying is controversial. This study measures the long-term follow-up of gastric emptying in children who have undergone gastroesophageal fundoplication combined with antroplasty.


METHODS
Fifteen randomly selected children with gastroesophageal reflux and scintigraphically demonstrated delayed gastric emptying underwent fundoplication and antroplasty. Each patient had another gastric emptying scintigraphic study performed an average of 3.6 years postoperation.


RESULTS
All patients reported improvement of their symptoms compared with before the operation, and none required further medical therapy for gastroesophageal reflux or experienced dumping syndrome. Eleven of the 15 patients had significant long-term improvement of their gastric emptying postoperatively. The mean percent of isotope meal remaining in the stomach at 90 minutes improved from 72% preoperatively to 40% postoperatively (P = 0.0005).


CONCLUSIONS
Gastric emptying in children with gastroesophageal reflux and delayed gastric emptying is significantly improved for several years in three-fourths of patients after fundoplication and antroplasty. Fundoplication and concomitant antroplasty are recommended for symptomatic children with documented gastroesophageal reflux and delayed gastric emptying.
Dunn
J C
JC
Department of Nuclear Medicine, UCLA School of Medicine, Los Angeles, California 90095, USA.
Lai
E C
EC
Webber
M M
MM
Ament
M E
ME
Fonkalsrud
E W
EW
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D018662:Fundoplication; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007223:Infant; D011706:Pyloric Antrum / Q000601:surgery*; D011877:Radionuclide Imaging; D011897:Random Allocation; D012008:Recurrence; D013270:Stomach / Q000000981:diagnostic imaging; D013997:Time Factors