title: Thirty-day outcome in children randomized to open and laparoscopic Nissen fundoplication.
abstract: BACKGROUND
  Laparoscopic Nissen fundoplication (LNF) is considered by some to be superior to open Nissen fundoplication (ONF). To test this hypothesis, we compared early results after LNF and ONF in a randomized trial.
  
  
  METHODS
  All children accepted for antireflux surgery for gastroesophageal reflux disease were offered enrollment. Ethical approval and parental consent were obtained. Anesthesia, surgical methods, and postoperative treatment were standardized. Patient demographics, length of hospital stay (LOS), and complications occurring the first 30 postoperative days were registered.
  
  
  RESULTS
  Eighty-eight children were randomized to LNF (n = 44) or ONF (n = 44). The groups were comparable with regard to age, weight, and comorbidity. Duration of surgery was 150 ± 34 minutes for LNF and 89 ± 25 minutes for ONF (P < .001). Median LOS was 7.0 days (range, 3-57 days) and 7.5 days (range, 2-20 days) after LNF and ONF, respectively (P = .74). Postoperative complications occurred in 48 patients, 24 in both groups. Twenty-four patients (LNF: n = 12, ONF: n = 11) were readmitted to hospital because of complications occurring after discharge.
  
  
  CONCLUSIONS
  This study failed to show that LNF is superior to ONF when surgery duration, LOS, and complications occurring during the first postoperative month were compared. Apart from surgery duration, the results were surprisingly similar.
authors.affiliation: Faculty of Medicine, University of Oslo, 0316 Oslo, Norway. charlotte@knatten.org
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Knatten
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Fyhn
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.forename: Ole
authors.initials: O
authors.lastname: Schistad
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Emblem
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjørnland
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome