title: Laparoscopic antireflux surgery increases health-related quality of life in children with GERD.
abstract: Improving health-related quality of life (HRQoL) is increasingly recognized as an essential part of patient care outcome. Little is known about the effect of laparoscopic antireflux surgery (LARS) on the HRQoL in the pediatric patients. The aims of this study were to evaluate the effect of LARS on HRQoL in children with gastroesophageal reflux disease (GERD) and to identify predictors that influence HRQoL outcome after LARS.
  
  
  
  Between 2011 and 2013, 25 patients with therapy-resistant GERD [median age 6 (2-18) years] were included prospectively. Caregivers and children with normal neurodevelopment (>4 years) were asked to fill out the validated PedsQL 4.0 Generic Core Scales before and 3-4 months after LARS.
  
  
  
  The PedsQL was completed by all caregivers (n = 25) and 12 children. HRQoL total score improved significantly after LARS, both from a parental (p = 0.009) and child's perspective (p = 0.018). The psychosocial health summary and physical health summary scores also improved significantly after LARS. HRQoL before and after LARS was significantly lower in children with impaired neurodevelopment (p < 0.001). However, neurodevelopment did not influence the effect of LARS on HRQoL. The only significant predictor for improvement in HRQoL after LARS was age at the time of operation (p = 0.001).
  
  
  
  HRQoL significantly improves after LARS. Although children with impaired neurodevelopment had lower overall HRQoL, neurodevelopment by itself does not predict inferior improvement in HRQoL after LARS. Older children have a more favorable HRQoL outcome after LARS compared to younger children. This may suggest caution when considering LARS in younger GERD patients.
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Room: KE.04.140.5, PO Box 85090, 3508 AB, Utrecht, The Netherlands. femkemauritz@gmail.com.|Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands. femkemauritz@gmail.com.
authors.forename: Femke A
authors.identifier: 0000-0003-1829-4695
authors.initials: FA
authors.lastname: Mauritz
authors.affiliation: Department of Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Stellato
authors.affiliation: Department of Pediatric Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: L W Ernst
authors.initials: LWE
authors.lastname: van Heurn
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.affiliation: Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Cornelius E J
authors.initials: CEJ
authors.lastname: Sloots
authors.affiliation: Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Roderick H J
authors.initials: RHJ
authors.lastname: Houwen
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Room: KE.04.140.5, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: David C
authors.initials: DC
authors.lastname: van der Zee
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Room: KE.04.140.5, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
authors.forename: Maud Y A
authors.initials: MYA
authors.lastname: van Herwaarden-Lindeboom
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006304:Health Status; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Antireflux surgery; Children; Fundoplication; GERD; Pediatric; Quality of life; Reflux