title: Outcomes of surgical fundoplication in children.
abstract: OBJECTIVE
  Surgical fundoplication has been recommended for children with persistent GERD. The purpose of this study was to determine the frequency of postoperative symptoms requiring medical evaluation and/or treatment after fundoplication in children with or without associated medical disorders.
  
  
  METHODS
  In a retrospective cohort study, we reviewed the medical records of all children who underwent fundoplication during 1996-1999. Data were collected to analyze the following: (1) postoperative complications, (2) postoperative symptoms, (3) procedures performed to evaluate postoperative symptoms, (4) medical treatment, and (5) repeat surgery.
  
  
  RESULTS
  A total of 198 children underwent fundoplication, and 176 (89%) came for follow-up evaluation within 2 months after surgery. The median age at the time of surgery was 2.1 y (range, 6 mo-18 y) and the median duration of follow-up was 2.0 y (range, 1.2-4.8 y). A total of 130 (74%) children had one or more associated medical disorders including neurodevelopmental delay (70%), cystic fibrosis (8%), tracheoesophageal anomalies (8%), bronchopulmonary dysplasia (8%), and reactive airway disease (35%). Postoperatively, children with associated medical disorders had a higher frequency of lung infections (52% vs. 22%, P = .03) and dumping syndrome (2% vs. 0%, P = .05). Most children (63%) received evaluation and treatment for symptoms suggestive of recurrent reflux despite fundoplication.
  
  
  CONCLUSIONS
  Nearly two thirds of children who received fundoplication and were followed-up within 2 months after surgery either have symptoms or receive medical therapy for reflux. Fundoplication for the control of GERD in children needs further evaluation.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gilger
authors.forename: Christine
authors.initials: C
authors.lastname: Yeh
authors.forename: Jim
authors.initials: J
authors.lastname: Chiang
authors.forename: Craig
authors.initials: C
authors.lastname: Dietrich
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome