title: Nissen fundoplication in children with and without neurological impairment: A prospective cohort study.
abstract: BACKGROUND
  It is assumed that children with neurological impairment (NI) have inferior results after fundoplication compared to those without NI (non-NI). The aim of this study was to assess outcome after fundoplication in children with and without NI.
  
  
  METHODS
  87/105 patients (46 NI, 41 non-NI) undergoing fundoplication between 2003 and 2009 were included in this prospective two-center cohort study. Complications occurring within the first 30days were scored from 0 to 100 by the comprehensive complication index (CCI). Follow-up included clinical examination, upper gastrointestinal contrast study and 24-h pH monitoring 6months postoperatively, then phone-interviews 1, 2 and 4years later.
  
  
  RESULTS
  There were no statistical differences in age (NI 3.1 years [0.2-15.2] vs non-NI 5.0 years [0.4-15], p=.14) or in total CCI score (NI 20.9 [0-44.9] vs non-NI 8.7 [0-40.6], p=.57). Hospital stay was longer for NI children (9days [4-57] vs non-NI: 4days [2-16], p<0.001). More than 90% of parents in both groups reported that the fundoplication had improved the child's overall condition. Recurrence of gastroesophageal reflux disease (GERD) was diagnosed in 12 NI and 7 non-NI patients (p=.31).
  
  
  CONCLUSIONS
  Early complications, GERD recurrence, and long-term parental satisfaction after fundoplication did not differ between NI and non-NI patients.
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Rikshospitalet, Norway. Electronic address: charlotte@knatten.org.
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Knatten
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Kvello
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Fyhn
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Intervention Centre, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.affiliation: Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Ullevål, Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Schistad
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastroenterology, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Aabakken
authors.affiliation: Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Norway.
authors.forename: Are H
authors.initials: AH
authors.lastname: Pripp
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Heidi
authors.initials: H
authors.lastname: Kjosbakken
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Emblem
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Norway; Department of Gastrointestinal and Pediatric surgery, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjørnland
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Antireflux surgery; Child; Fundoplication; GER; Gastroesophageal reflux; Gerd