title: Long-term outcome of laparoscopic Nissen and Toupet fundoplication in normal and neurologically impaired children.
abstract: BACKGROUND
  Laparoscopic fundoplication is a commonly performed procedure in children. This report describes the incidence of long-term recurrence and complications after laparoscopic Nissen or Toupet fundoplication in neurologically impaired and normal children.
  
  
  METHODS
  Fifty-three children operated on before 1999 were reviewed. All children were evaluated clinically and with a barium meal study thereafter. Symptomatic children and those with abnormal barium meal underwent 24 h pH monitoring.
  
  
  RESULTS
  A total of 45 patients were included in the study. The mean follow-up was 4.5 years. All, except one asymptomatic child that declined, had a barium meal. Four were abnormal (2 parahiatal hernias and 2 slight episodes of reflux). Four patients had symptoms related to the operation and 2 to clinical recurrence. Only 1 asymptomatic child with slight reflux at barium meal revealed abnormal 24 h pH monitoring. Finally, 6.6% patients were found to have late recurrence (2 clinical and 1 pHmetry). There was an obvious increase in children's weight, especially in neurologically impaired patients.
  
  
  CONCLUSIONS
  Laparoscopic antireflux surgery is of value in children with gastroesophageal reflux disease. The long-term results are comparable with open surgery, and there was no difference in term of wrap failure between neurologically impaired and normal children.
authors.affiliation: Department of Pediatric Surgery, Fondation Lenval pour Enfants, 57, Avenue de la Californie, F 06200, Nice, France. henri.steyaert@lenval.com
authors.forename: H
authors.initials: H
authors.lastname: Steyaert
authors.forename: M
authors.initials: M
authors.lastname: Al Mohaidly
authors.forename: M A
authors.initials: MA
authors.lastname: Lembo
authors.forename: L
authors.initials: L
authors.lastname: Carfagna
authors.forename: S
authors.initials: S
authors.lastname: Tursini
authors.forename: J S
authors.initials: JS
authors.lastname: Valla
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome