title: Outcomes of fundoplication for paediatric gastroesophageal reflux disease.
abstract: OBJECTIVE
  Outcomes of fundoplication in children.
  
  
  METHODS
  In this monocentric retrospective study, chart review was performed on children who underwent fundoplication between 2006 and 2013. Outcomes were defined as the need for redo fundoplication and recommencement of anti-reflux medication (ARM) at 6-month follow-up.
  
  
  RESULTS
  119 patients underwent fundoplication with a mean age of 4.76 years and 55.5% of these were male. At 6-month follow-up, 21 (17.6%) required redo fundoplication and 64 (53.8%) were recommenced on ARM. Post-operative complications occurred in 50 (42.2%) of children; 30% of those with complications had surgery at less than 1 year of age, and 36% had an associated comorbid condition. Neither being under the age of one nor associated comorbidity was significantly associated with a poor outcome. Concurrent gastrostomy was associated with a higher risk of being back on ARM at 6-month follow-up (p = 0.003). Neither gastrointestinal or respiratory symptoms pre-surgery nor abnormal pre-operative investigations including pH monitoring and endoscopy were predictive of poor outcome post-fundoplication.
  
  
  CONCLUSIONS
  Although fundoplication has a role in the treatment of severe GORD in children, the majority of children in this study needed to restart their anti-reflux medications within 6 months of surgery.
authors.affiliation: Sydney Children's Hospital Randwick (SCH), Sydney, Australia. Emily.pascoe@health.nsw.gov.au.
authors.forename: E
authors.identifier: http://orcid.org/0000-0001-6306-4560
authors.initials: E
authors.lastname: Pascoe
authors.affiliation: University of New South Wales (UNSW), Sydney, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Falvey
authors.affiliation: Department of Paediatric Surgery, SCH, Sydney, Australia.|School of Women's and Children's Health, UNSW, Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Jiwane
authors.affiliation: Department of Paediatric Surgery, SCH, Sydney, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Henry
authors.affiliation: School of Women's and Children's Health, UNSW, Sydney, Australia.|Department of Paediatric Gastroenterology, SCH, Sydney, Australia.
authors.forename: U
authors.initials: U
authors.lastname: Krishnan
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Complications; Fundoplication; Gastroesophageal reflux disease; Medication; Paediatric