A new and successful chance in surgical treatment of gastrooesophageal reflux in severely neurologically impaired children: Bianchi's procedure.
OBJECTIVE
Neurologically impaired (NI) children present with neuromuscular incoordination and severe gastroesophageal reflux (GER). In these cases, Bianchi has proposed total oesophagogastric dissociation (OGD) as a primary procedure and not only after failed fundoplication.


METHODS
Anthropometric and laboratory data, incidence of respiratory symptoms, days of hospitalisation, time of feeding, stool frequency and quality of life were tested preoperatively and after OGD over a 12-month period in 13 severe NI patients.


RESULTS
Results are shown in Table 1. We also recorded improvement in quality of life, based on communication by the person responsible for the care of the subject, and determined by psychological interviews.


CONCLUSIONS
OGD is a successful and feasible procedure and can be included as a primary definitive surgical treatment in individualised nutritional rehabilitation planning for each severe NI child.
Dall'Oglio
L
L
Digestive Surgery Unit, Ospedale Pediatrico Bambino Gesù-IRCCS, Rome, Italy.
Gatti
C
C
Villa
M
M
Amendola
S
S
La Sala
E
E
Frederici di Abriola
G
G
D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D009468:Neuromuscular Diseases / Q000209:etiology / Q000601:surgery*; D011788:Quality of Life; D016896:Treatment Outcome