LAPAROSCOPIC NISSEN FUNDOPLICATION WITH SIMULTANEOUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN CHILDREN

Background: The aim of the study was to evaluate the results of laparo scopic Nissen fundoplication (LNF) with simultaneous percutaneous endo scopic gastrostomy (PEG) in children with gastroesophageal reflux (GER ) disease documented by upper gastrointestinal contrast and/or pH moni toring and/or esophageal endoscopy. Methods: Fifteen LNF + PEGs were p erformed in children with pathologic antecedents: ten neurologically i mpaired children, two ORL (otorhinolaryngeal) pathologies. Two cases o f AIDS, and one neuroblastoma, In one case, disruption of the fundopli cation occurred during insufflation of the stomach. The child was reop erated on the 3rd day using an open procedure, so she was excluded fro m the results of the LNF. Results: Two children had postoperative comp lications: one with cardiac insufficiency, one case of dehydration. Fo urteen LNFs were controlled at 3 months by gastroesophageal X-ray and pH-metry, The 14 gastroesophageal X-rays were normal in 12 cases; gast roesophageal reflux was present in two cases, Twelve pH monitorings we re analyzed (two technical failures), the median time pH <4 was 0.2% ( 0-20), Only one pH monitoring was pathologic (pH <4: 20%), This recurr ent reflux to led to a second LNF with a good clinical result. Conclus ions: In conclusion, it is possible to perform LNF and PEG during the same operative procedure. Short-term results are satisfactory with 14% recurrent GER. Long-term results need to be evaluated.