title: Complete vs partial fundoplication in children with esophageal atresia.
abstract: OBJECTIVE
  The purpose of the study was to compare outcomes after partial vs complete fundoplication in patients with prior esophageal atresia repair.
  
  
  METHODS
  All patients undergoing fundoplication following esophageal atresia repair at a tertiary care pediatric hospital from 1987 to 2006 were retrospectively reviewed. All children had at least 1 year of follow-up postfundoplication.
  
  
  RESULTS
  Of 47 children, 31 (66%) had a partial fundoplication and 16 (34%) had complete fundoplication. Demographics, presence of tracheoesophageal fistula, early complications of esophageal atresia repair, gastroesophageal reflux symptoms before fundoplication, and operative details of fundoplication were statistically similar between groups, except for the frequency of hiatus repair during fundoplication (23% vs 69%, P = .004). Patients were followed for a median of 4.98 years (range, 1-17.8 years). Postfundoplication symptoms of vomiting (39% vs 31%), dysphagia (45% vs 38%), retching (10% vs 25%), abnormal findings on barium study, and need for reoperation (19% vs 13%) were not statistically different between groups. However, a greater proportion of children undergoing partial fundoplication achieved long-term symptom- and medication-free recovery (52% vs 13%, P = .012).
  
  
  CONCLUSIONS
  Our data suggest that partial fundoplication is associated with a greater likelihood of symptom- and medication-free recovery than complete fundoplication in children with previously repaired esophageal atresia.
authors: Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Canada M5G 1X8.
authors: David N
authors: DN
authors: Levin
authors: Ivan R
authors: IR
authors: Diamond
authors: Jacob C
authors: JC
authors: Langer