TY - JOUR
T1 - A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population
AU - Thatch, Keith A.
AU - Yoo, Edward Y.
AU - Arthur, L. Grier
AU - Finck, Christine
AU - Katz, Douglas
AU - Moront, Matthew
AU - Prasad, Rajeev
AU - Vinocur, Charles
AU - Schwartz, Marshall Z.
PY - 2010/2
Y1 - 2010/2
N2 - Introduction: The aim of this study was to compare outcomes after laparoscopic and open techniques for Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit (NICU) population. Methods: The medical records for NICU inpatients who underwent laparoscopic and open Nissen fundoplication and gastrostomy placement from August 2002 to August 2008 were reviewed after Institutional Review Board approval. Each technique was compared with regard to operative time, estimated blood loss, postoperative 24-hour narcotic requirements, time to goal feeds, and complication rates. Analysis of variance was used to determine statistical significance. Data are quoted as mean ± SEM. Results: Fifty-seven NICU patients underwent fundoplication and gastrostomy placement (25 laparoscopic and 32 open). The time to goal feeds was significantly shorter for the laparoscopic group (4.3 ± 0.4 vs 6.1 ± 0.6 days, P = .04). The 24-hour postoperative narcotic requirement was significantly lower in the laparoscopic group (0.24 ± 0.05 vs 0.55 ± 0.08 mg/kg, P = .007). Operation times (111 ± 5 [open] vs 113 ± 5 minutes, P = .76) and estimated blood loss (13 ± 2 [open] vs 11 ± 1 mL, P = .33) were comparable for both groups. Conclusion: Laparoscopic and open techniques for Nissen fundoplication with gastrostomy placement are safe and appropriate treatment methods with equivalent operating times for the treatment of gastroesophageal reflux in the NICU population.
AB - Introduction: The aim of this study was to compare outcomes after laparoscopic and open techniques for Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit (NICU) population. Methods: The medical records for NICU inpatients who underwent laparoscopic and open Nissen fundoplication and gastrostomy placement from August 2002 to August 2008 were reviewed after Institutional Review Board approval. Each technique was compared with regard to operative time, estimated blood loss, postoperative 24-hour narcotic requirements, time to goal feeds, and complication rates. Analysis of variance was used to determine statistical significance. Data are quoted as mean ± SEM. Results: Fifty-seven NICU patients underwent fundoplication and gastrostomy placement (25 laparoscopic and 32 open). The time to goal feeds was significantly shorter for the laparoscopic group (4.3 ± 0.4 vs 6.1 ± 0.6 days, P = .04). The 24-hour postoperative narcotic requirement was significantly lower in the laparoscopic group (0.24 ± 0.05 vs 0.55 ± 0.08 mg/kg, P = .007). Operation times (111 ± 5 [open] vs 113 ± 5 minutes, P = .76) and estimated blood loss (13 ± 2 [open] vs 11 ± 1 mL, P = .33) were comparable for both groups. Conclusion: Laparoscopic and open techniques for Nissen fundoplication with gastrostomy placement are safe and appropriate treatment methods with equivalent operating times for the treatment of gastroesophageal reflux in the NICU population.
KW - Gastrostomy
KW - Laparoscopic fundoplication
KW - Neonatal antireflux surgery
KW - Neonatal laparoscopy
KW - Nissen fundoplication
KW - Open fundoplication
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U2 - 10.1016/j.jpedsurg.2009.10.073
DO - 10.1016/j.jpedsurg.2009.10.073
M3 - Article
C2 - 20152349
AN - SCOPUS:75749138142
SN - 0022-3468
VL - 45
SP - 346
EP - 349
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 2
ER -