title: Parents reported reduced symptoms and improved satisfaction after fundoplication and their perceptions were an important outcome measure.
abstract: OBJECTIVE
  Fundoplication is required for children with chronic recurrent gastro-oesophageal reflux disease (GERD). The aim of this study was to report parental perceptions of symptoms and overall satisfaction with the long-term course following fundoplication with special reference to patients with GERD risk factors.
  
  
  METHODS
  We studied 34 patients, with a median age of 6.5 ± 4.9 years, who received fundoplication between 2001 and 2005. Clinical information and surgical complications were recorded. Parents were interviewed to evaluate post-operative symptoms, mode of nutrition and satisfaction.
  
  
  RESULTS
  The median follow-up time was 7.3 years. Comorbidities were neurological impairment in 15 patients, other gastrointestinal disorders in seven patients and isolated GERD in 12 patients. The parents reported that fundoplication effectively treated initial reflux symptoms in 60% and improved symptoms in 37%. Vomiting and reflux-associated pain were treated most effectively. Pulmonary symptoms often remained unchanged in neurologically impaired children. Redo fundoplication was necessary in seven patients. Only two parents regretted consenting to surgery.
  
  
  CONCLUSIONS
  A high percentage of parents reported improved gastrointestinal reflux-related symptoms and a high level of satisfaction following fundoplication. Parental perceptions of GERD symptoms should be an important outcome measure when assessing the efficacy of antireflux surgery in children in routine clinical follow-up.
authors.affiliation: Department of Pediatric Surgery, Dr. v. Hauner Children's Hospital, LMU Munich, Munich, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Heinrich
authors.affiliation: Department of Pediatric Surgery, Dr. v. Hauner Children's Hospital, LMU Munich, Munich, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kain
authors.affiliation: Department of Pediatric Surgery, Dr. v. Hauner Children's Hospital, LMU Munich, Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Bergmann
authors.affiliation: Department of Pediatric Surgery, Dr. v. Hauner Children's Hospital, LMU Munich, Munich, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: von Schweinitz
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Antireflux surgery; Fundoplication; Gastro-oesophageal reflux disease comorbidities; Parental perceptions