A multicenter study of the incidence and factors associated with redo Nissen fundoplication in children

作者：Baerg Joanne^*; Thorpe Donna; Bultron Gilberto; Vannix Rosemary; Knott E Marty; Gasior Alessandra C; Sharp Susan W; Tagge Edward; St Peter Shawn D

来源：Journal of Pediatric Surgery, 2013, 48(6): 1306-1311.

DOI：10.1016/j.jpedsurg.2013.03.028

• Pediatric gastroesophageal reflux disease
• Redo Nissen fundoplication

Aim: The objective of this study was to identify the incidence and factors associated with redo Nissen fundoplication in children. %26lt;br%26gt;Methods: After Institutional Review Board approval (5100277), data for children under 18 years of age from two children%26apos;s hospitals with fundoplication performed between January 1994 and December 2010 were reviewed. Children with one fundoplication were compared to those with redos to identify factors associated with redo. %26lt;br%26gt;Variables were compared using t-tests for continuous and chi-square tests for categorical variables. Logistic regression evaluated for independence. %26lt;br%26gt;Results: There were 823 patients and 54.7% were male. A redo fundoplication was required in 100 (12.2% of cohort); 82 had 1 redo, 14 had 2 redos, and 4 had 3 redos. Follow-up ranged from 0.01 to 16.9 years (median: 2.9 years). %26lt;br%26gt;Factors associated with redo were: younger age at first fundoplication, (p = 0.002), hiatal dissection (p %26lt; 0.001), and male gender (p = 0.008). Independent predictors of redo were: hiatal dissection at first fundoplication, OR: 8.45 (95% CI: 2.45-29.11), retching, OR: 3.59 (95% CI: 1.56-8.25) and younger age at first fundoplication, OR: 0.98 (95% CI: 0.97-0.98). %26lt;br%26gt;Conclusion: The incidence of redo fundoplication in children is 12.2%. The risk of redo is significantly increased if patients are younger, have retching, and if the esophageal hiatus is dissected at the first fundoplication.

• 出版日期2013-6