Laparoscopic Toupet fundoplication for gastroesophageal reflux: a series of 131 neurologically impaired pediatric cases at a single children’s hospital

Go Miyano, Masaya Yamoto, Keiichi Morita, Masakatsu Kaneshiro, Hiromu Miyake, Hiroshi Nouso, Mariko Koyama, Hideaki Nakajima, Koji Fukumoto, Naoto Urushihara

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5 Citations (Scopus)


Purpose: To present the medium to long-term outcome of the largest pediatric series of laparoscopic Toupet fundoplications (LTF) performed at a single institution. Patients and methods: Subjects were 131 neurologically impaired children (81 M, 50 F) who underwent LTF between 2003 and 2013. Our LTF involves full dissection of the crus of the diaphragm to allow the intraabdominal esophagus to be mobilized at least 3–4 cm. Results: Preoperative mean fraction time for pH <4 was 14.6 %. Mean age at LTF was 6.7 years (3 months–18 years). Mean duration of follow-up was 5.7 years (range 1.2–12.1 years). One case required conversion to open surgery. Intra-operative complications were all injuries to the esophagus/gastric wall (n = 4; 3.0 %) including full-thickness perforation (n = 1; 0.8 %). Postoperative complications included pyloric stenosis (n = 4; 3.0 %), dysphagia (n = 1; 0.8 %), incisional hernia (n = 1; 0.8 %), hemorrhage requiring transfusion (n = 1; 0.8 %), recurrence (n = 3; 2.3 % at 11, 13, and 48 months, respectively), and gastrostomy site infection (n = 7; 5.3 %). Mean operative time decreased significantly with experience from 180.8 min for the first quarter of subjects to 150.6 (2nd quarter), 128.6 (3rd) and 109.2 min (4th). Conclusions: Our LTF would appear to be safe for treating GERD in children because of reliable outcome and low recurrence.

Original languageEnglish
Pages (from-to)925-929
Number of pages5
JournalPediatric Surgery International
Issue number10
Publication statusPublished - Oct 22 2015
Externally publishedYes



  • Gastroesophageal reflux
  • Laparoscopy
  • Toupet fundoplication

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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