Gastric emptying scans: unnecessary preoperative testing for fundoplications?
OBJECTIVE
Delayed gastric emptying (DGE) as indicated by preoperative gastric emptying scan (GES) is one rationale for performing a gastric emptying procedure (GEP) at time of fundoplication for gastroesophageal reflux disease (GERD). However, the role of GES and GEP in the surgical management of GERD remains unclear. We examined the use of preoperative GES in fundoplication patients.


METHODS
Retrospective chart review of patients undergoing fundoplication from 2000 to 2005 in a single institution including patient demographics, operative procedure, and postoperative outcomes at 1-year follow-up was analyzed using chi(2) test.


RESULTS
Of 76 fundoplication patients, 39 (51%) had preoperative GES with 11 patients (28%) having DGE and 16 GEP performed. Developmentally delayed children were more likely to have GES. There were no significant differences in postoperative complications, length of hospital stay, or use of anti-GERD medications at 1 year between patients who had preoperative GES and those who did not. In the developmentally delayed group, there were no differences in outcomes between those with preoperative GES and those who did not.


CONCLUSIONS
There were no differences in outcomes for GERD patients with or without preoperative GES or GEP postfundoplication. The use of GES in the management of GERD requires further evaluation.
Department of Pediatric Surgery, Erasmus MC-Sophia, Rotterdam, The Netherlands.
Marie-Chantal
MC
Struijs
David
D
Lasko
Stig
S
Somme
Priscilla
P
Chiu
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D011877:Radionuclide Imaging / Q000379:methods; D012189:Retrospective Studies; D013270:Stomach / Q000000981:diagnostic imaging*; D016896:Treatment Outcome