title: Laparoscopic fundoplication in children with a preexisting gastrostomy.
abstract: BACKGROUND
  Children with a gastrostomy may require laparoscopic fundoplication (LF).
  
  
  METHODS
  Children with a gastrostomy who underwent LF between 1998 and 2002 were reviewed. The outcomes of children undergoing LF were compared with a group of children without a gastrostomy who had the same operation during the same period.
  
  
  RESULTS
  Ten children with a gastrostomy in place and eight children without a gastrostomy underwent LF. The median operating time was 198 minutes (range, 115-300 minutes) in the gastrostomy group and 110 minutes (range, 80-130 minutes) in the non-gastrostomy group (P =.002). In the gastrostomy group, two children had ventriculoperitoneal shunts and two had extensive intra-abdominal adhesions due to peritonitis. One laparoscopic procedure in each group was converted to an open approach. A successful LF was performed in nine of the ten children without taking down the gastrostomy. One child with a gastrostomy experienced recurrent vomiting that was managed with a gastrojejunal tube. One child in the non-gastrostomy group required reoperation due to an esophageal stricture.
  
  
  CONCLUSIONS
  It seems that LF can be performed safely and effectively in children with a preexisting gastrostomy. LF in children with a gastrostomy seems to be as efficacious as LF in children without a gastrostomy.
authors.affiliation: Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland. hannu.lintula@kuh.fi
authors.forename: Hannu
authors.initials: H
authors.lastname: Lintula
authors.forename: Pentti
authors.initials: P
authors.lastname: Antila
authors.forename: Hannu
authors.initials: H
authors.lastname: Kokki
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male