A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population

Keith A. Thatch, Edward Y. Yoo, L. Grier Arthur, Christine Finck, Douglas Katz, Matthew Moront, Rajeev Prasad, Charles Vinocur, Marshall Z. Schwartz

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)346-349
Number of pages4
JournalJournal of pediatric surgery
Volume45
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

Keywords

  • Gastrostomy
  • Laparoscopic fundoplication
  • Neonatal antireflux surgery
  • Neonatal laparoscopy
  • Nissen fundoplication
  • Open fundoplication

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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