期刊
JOURNAL OF PEDIATRIC SURGERY
卷 50, 期 5, 页码 707-714出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2015.02.020
关键词
Fundoplication; Gastrojejunostomy; Children; Gastroesophageal reflux; Neurological impairment
Background: Children with neurologic impairment often fail medical management of gastroesophageal reflux and proceed to fundoplication and gastrostomy (FG) or percutaneous gastrojejunostomy (GJ). Current guidelines do not recommend one treatment over the other, and there is ongoing uncertainty regarding clinical management. Methods: We conducted a structured search of Medline, Embase, trial registries, and the gray literature. We included studies that compared outcomes for FG and GJ in children with neurologic impairment. Results: We identified 556 children from three retrospective studies who underwent FG (n = 431) or GJ (n = 125). There were no differences in rates of pneumonia (17% vs 19%, p = 0.74) or mortality (13% vs 14%, p = 0.76). Few deaths were due to procedural complications (1%) or reflux (2%). There was a trend towards more major complications with FG (29%) compared to GJ (12%) (risk ratio = 1.70, 0.85-3.41, p = 0.14). Minor complications were more common with GJ (70%) than FG (45%), but this difference was also not statistically significant (risk ratio = 0.38, 0.05-3.07, p = 0.36). No studies reported quality of life using validated measures. Conclusions: The quality of the evidence for outcomes of FG versus GJ is very low. Large comparative studies are needed to determine which approach is associated with the best quality-of-life outcomes. (C) 2015 Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据