title: Laparoscopic versus open Nissen fundoplication in children: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review and meta-analyze studies that have compared the clinical outcomes of laparoscopic and open Nissen fundoplication on children.
  
  
  METHODS
  Online databases were searched to identify studies that have compared the laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) on children, looking specifically for operative time, time to full feed, redo fundoplication rates and total postoperative complications including wound infection, retching, and airway complications.
  
  
  RESULTS
  Of those 916 patients in the 9 selected studies, 557 and 359 patients had undergone LNF and ONF, respectively; and LNF had significant longer operative time and less total postoperative complications including retching and airway complications than ONF. However, no significant difference in time to full feed, wound infection, and redo fundoplication rates was found between LNF and ONF in children.
  
  
  CONCLUSIONS
  LNF is a safe, feasible, and effective surgical procedure alternative to ONF for gastroesophageal reflux in children. Compared with ONF, LNF has the advantage of less total postoperative complications including retching and airway complications. In addition, LNF is comparable to ONF in terms of time to full feed, wound infection, and redo fundoplication rates. Therefore, we conclude that LNF should be regarded as an acceptable option for children.
authors: Department of Urology and Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
authors: Wei
authors: W
authors: Ru
authors: Department of Pediatric Surgery, Northwest Women and Children's Hospital (Shaanxi Provincial Maternity Hospital), Xi'an, Shaanxi, China.
authors: Peng
authors: P
authors: Wu
authors: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, China.
authors: Shaoguang
authors: S
authors: Feng
authors: Institute of Inflammation and Diseases, Institute of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors: Xin-He
authors: XH
authors: Lai
authors: Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: jackiefung@163.com.
authors: Guorong
authors: G
authors: Chen
mesh_terms: D002648:Child; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D061646:Operative Time; D016896:Treatment Outcome
keywords: Children; Laparoscopic; Meta-analysis; Open Nissen fundoplication