Current status of surgical management of gastroesophageal reflux in children.
Curr Opin Pediatr
; 28(3): 356-62, 2016 06.
Article
en En
| MEDLINE
| ID: mdl-27138806
PURPOSE OF REVIEW: Surgical therapy for gastroesophageal reflux disease (GERD) is controversial with considerable debate ranging from the indications for antireflux surgery to surgical technique. This article will attempt to clarify these issues with the most up-to-date information available on the prevalence, pathophysiology, diagnosis, and surgical treatment of GERD in children. Although laparoscopic Nissen fundoplication (LNF) has become the most popular operation performed for pathologic reflux, its superiority over both open surgery and other types of fundoplication is not well established. RECENT FINDINGS: Large retrospective studies suggest LNF has a lower complication rate than open surgery. However, three prospective randomized controlled trials have been published recently which cast doubt on the superiority of LNF and suggest that LNF may have a higher failure rate compared to open fundoplication. Antireflux surgery has higher morbidity and failure rates in infants and in children with neurologic impairment. SUMMARY: Based on the best available evidence, LNF may be less morbid, but have a higher rate of failure than open surgery. Pediatric surgeons should be mindful of the risks and benefits of both approaches to best counsel their patients. Larger prospective randomized controlled trials are needed to determine the best treatments for pediatric GERD.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Reflujo Gastroesofágico
/
Endoscopía Gastrointestinal
/
Laparoscopía
/
Fundoplicación
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
Curr Opin Pediatr
Asunto de la revista:
PEDIATRIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos