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

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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
Volume31
Issue number10
DOIs
Publication statusPublished - Oct 22 2015
Externally publishedYes

Fingerprint

Fundoplication
Gastroesophageal Reflux
Pediatrics
Esophagus
Pyloric Stenosis
Conversion to Open Surgery
Recurrence
Gastrostomy
Operative Time
Deglutition Disorders
Diaphragm
Dissection
Stomach
Hemorrhage
Wounds and Injuries
Infection

Keywords

  • Gastroesophageal reflux
  • Laparoscopy
  • Toupet fundoplication

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Laparoscopic Toupet fundoplication for gastroesophageal reflux : a series of 131 neurologically impaired pediatric cases at a single children’s hospital. / Miyano, Go; Yamoto, Masaya; Morita, Keiichi; Kaneshiro, Masakatsu; Miyake, Hiromu; Nouso, Hiroshi; Koyama, Mariko; Nakajima, Hideaki; Fukumoto, Koji; Urushihara, Naoto.

In: Pediatric Surgery International, Vol. 31, No. 10, 22.10.2015, p. 925-929.

Research output: Contribution to journalArticle

Miyano, Go ; Yamoto, Masaya ; Morita, Keiichi ; Kaneshiro, Masakatsu ; Miyake, Hiromu ; Nouso, Hiroshi ; Koyama, Mariko ; Nakajima, Hideaki ; Fukumoto, Koji ; Urushihara, Naoto. / Laparoscopic Toupet fundoplication for gastroesophageal reflux : a series of 131 neurologically impaired pediatric cases at a single children’s hospital. In: Pediatric Surgery International. 2015 ; Vol. 31, No. 10. pp. 925-929.
@article{82e656a9814240419432302d66b607ad,
title = "Laparoscopic Toupet fundoplication for gastroesophageal reflux: a series of 131 neurologically impaired pediatric cases at a single children’s hospital",
abstract = "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.",
keywords = "Gastroesophageal reflux, Laparoscopy, Toupet fundoplication",
author = "Go Miyano and Masaya Yamoto and Keiichi Morita and Masakatsu Kaneshiro and Hiromu Miyake and Hiroshi Nouso and Mariko Koyama and Hideaki Nakajima and Koji Fukumoto and Naoto Urushihara",
year = "2015",
month = "10",
day = "22",
doi = "10.1007/s00383-015-3770-4",
language = "English",
volume = "31",
pages = "925--929",
journal = "Pediatric Surgery International",
issn = "0179-0358",
publisher = "Springer Verlag",
number = "10",

}

TY - JOUR

T1 - Laparoscopic Toupet fundoplication for gastroesophageal reflux

T2 - a series of 131 neurologically impaired pediatric cases at a single children’s hospital

AU - Miyano, Go

AU - Yamoto, Masaya

AU - Morita, Keiichi

AU - Kaneshiro, Masakatsu

AU - Miyake, Hiromu

AU - Nouso, Hiroshi

AU - Koyama, Mariko

AU - Nakajima, Hideaki

AU - Fukumoto, Koji

AU - Urushihara, Naoto

PY - 2015/10/22

Y1 - 2015/10/22

N2 - 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.

AB - 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.

KW - Gastroesophageal reflux

KW - Laparoscopy

KW - Toupet fundoplication

UR - http://www.scopus.com/inward/record.url?scp=84941936494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941936494&partnerID=8YFLogxK

U2 - 10.1007/s00383-015-3770-4

DO - 10.1007/s00383-015-3770-4

M3 - Article

C2 - 26285893

AN - SCOPUS:84941936494

VL - 31

SP - 925

EP - 929

JO - Pediatric Surgery International

JF - Pediatric Surgery International

SN - 0179-0358

IS - 10

ER -