GASTROESOPHAGEAL REFLUX IN NEUROLOGICALLY IMPAIRED CHILDREN - PARTIALOR TOTAL FUNDOPLICATION

Background: It is difficult to give guidelines when approaching gastro esophageal disease in neurologically impaired children. Indication for surgery has been increasing over recent years, but there is no consen sus on the surgical technique of choice, Nothing has been written spec ifically comparing the results of different procedures in these patien ts, so far. Study design: We retrospectively compare the short- and lo ng-term results of two different types of fundoplication in a series o f children operated on for documented gastroesophageal reflux disease at our institution. Results: One group (group A) of 27 patients, opera ted on between 1977 and 1993, underwent Nissen fundoplication, the oth er (group B), formed of 20 patients all of whom were operated on betwe en 1993 and 1995, underwent Thal fundoplication. We compared the resul ts in terms of positive outcome (recovery) and negative outcome (minor and major complication), computing the relative odds of group A versu s group B in terms of risk of complication, and we compared the mean o perative time and the length of hospital stay by means of a student's t-test analysis. Conclusions. Our results show that there is no statis tical difference between the two procedures in terms of relative risk of complication and success rate. The duration of surgery and hospital stay were significantly shorter in group B, The Thal procedure can, t herefore, be proposed as first choice in the management of these patie nts.