Long-term outcome and efficiency of symptom-selective approach to assess gastroesophageal reflux prior to gastrostomy in neurologically impaired children
| Autor: | Vusale Elekberova, Coşkun Özcan, Hilmican Ulman, Zafer Dokumcu, Ata Erdener, Ulgen Celtik, Emre Divarci |
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| Přispěvatelé: | Ege Üniversitesi |
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Time Factors medicine.medical_treatment Fundoplication Nissen fundoplication 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Pediatric surgery medicine Humans Neurologically impaired Child Retrospective Studies Gastrostomy Routine screening business.industry Medical record fungi Preoperative screening Reflux Infant General Medicine Treatment Outcome Gastroesophageal reflux Child Preschool Esophagoplasty Pediatrics Perinatology and Child Health Female Laparoscopy 030211 gastroenterology & hepatology Surgery Nervous System Diseases business Follow-Up Studies |
| Zdroj: | Pediatric Surgery International. 37:903-909 |
| ISSN: | 1437-9813 0179-0358 |
| DOI: | 10.1007/s00383-021-04891-5 |
| Popis: | Purpose To evaluate the necessity of preoperative screening for gastroesophageal reflux (GER) prior to gastrostomy in neurologically impaired children. Methods Medical records of neurologically impaired children, who have undergone laparoscopic gastrostomy between January, 2004 and June, 2018, were retrospectively reviewed. Before the year of 2014, all patients who required gastrostomy had been routinely screened for GER pre-operatively, but after the year of 2014, only the ones with GER-related symptoms were tested. The characteristics and outcomes of Routine Screening (RS) and Selective Screening (SS) periods were compared. Results There were 55 and 54 patients in the RS and SS periods, respectively. Demographics, primary pathologies, and mean follow-up durations (> 2 years) were similar. The rate of GER screening was significantly lower in the SS period (29.6% vs. 63.6%). The rate of Laparoscopic Nissen Fundoplication (LNF) combined with gastrostomy was significantly lower in the SS period (14.8% vs. 38.2%). During follow-up, the rates of new-onset GER symptoms (13% vs. 11.7%) and LNF requirement later on (6.5% vs. 8.8%) were statistically similar between the two periods. Conclusion Routine screening for GER is not necessary prior to gastrostomy in neurologically impaired children. Symptom-selective screening algorithm is safe and efficient in the long term. |
| Databáze: | OpenAIRE |
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