Document Detail


A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population.
MedLine Citation:
PMID:  20152349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Keith A Thatch; Edward Y Yoo; L Grier Arthur; Christine Finck; Douglas Katz; Matthew Moront; Rajeev Prasad; Charles Vinocur; Marshall Z Schwartz
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  346-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
St Christopher's Hospital for Children/Drexel University College of Medicine, Philadelphia, PA 19134, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Distribution
Blood Loss, Surgical / statistics & numerical data
Child
Child, Preschool
Enteral Nutrition / statistics & numerical data
Female
Fundoplication / methods*,  statistics & numerical data
Gastroesophageal Reflux / surgery*
Gastrostomy / methods*
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal / statistics & numerical data
Intraoperative Period
Laparoscopy / methods*,  statistics & numerical data
Length of Stay
Male
Narcotics / administration & dosage,  therapeutic use
Pain, Postoperative / drug therapy,  epidemiology
Postoperative Complications / epidemiology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Narcotics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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