Long-term outcome of Boix-Ochoa and Nissen fundoplication in normal and neurologically impaired children

Purpose: The aim of this study was to compare the results of Boix-Ochoa and Nissen fundoplication performed in the authors' department in normal and n eurologically impaired children. Methods: The medical records of all children who underwent fundoplication i n the span of 10 years from 1988 to 1997 were reviewed. Boix-Ochoa procedur e was the preferred operation before 1993. Since 1993, the Nissen fundoplic ation has been used as the operation of choice for surgical antireflux trea tment. Results: A total of 109 fundoplications were performed during that period, of which 64.2% of the children involved were neurologically impaired. The B oix-Ochoa procedure and Nissen fundoplication were the 2 types of operation s performed for antireflux surgical treatment. There were 22 recurrences of gastroesophageal reflux, 14 in the neurologically impaired group and 6 in the normal group. All except 2 recurrences were after the Boix-Ochoa proced ure. Neurological impairment increased the morbidity rates after these proc edures and dictated the effectiveness of the operation. Nissen fundoplicati on fared better in comparison with the Boix-Ochoa procedure in both the neu rologically impaired and the normal group. Conclusions: Antireflux surgery is beneficial in children with significant gastroesophageal reflux, irrespective of their neurological status, althoug h complications are more common in the neurologically impaired group. Nisse n fundoplication is more effective and has fewer complications. J Pediatr S urg 35:1214-1216, Copyright (C) 2000 by W.B. Saunders Company.