Fundoplication in Patients with Esophageal Atresia : Patient Selection, Indications, and Outcomes

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http://hdl.handle.net/10138/188830

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Rintala , R J 2017 , ' Fundoplication in Patients with Esophageal Atresia : Patient Selection, Indications, and Outcomes ' , Frontiers in pediatrics , vol. 5 , 109 . https://doi.org/10.3389/fped.2017.00109

Title: Fundoplication in Patients with Esophageal Atresia : Patient Selection, Indications, and Outcomes
Author: Rintala, Risto J.
Contributor: University of Helsinki, Clinicum
Date: 2017-05-15
Language: eng
Number of pages: 5
Belongs to series: Frontiers in pediatrics
ISSN: 2296-2360
URI: http://hdl.handle.net/10138/188830
Abstract: Patients with esophageal atresia (EA) suffer from abnormal and permanent esophageal intrinsic and extrinsic innervation that affects severely esophageal motility. The repair of EA also results in esophageal shortening that affects distal esophageal sphincter mechanism. Consequently, gastroesophageal reflux (GER) is common in these patients, overall approximately half of them suffer from symptomatic reflux. GER in EA patients often resists medical therapy and anti-reflux surgery in the form of fundoplication is required. In patients with pure and long gap EA, the barrier mechanisms against reflux are even more damaged, therefore, most of these patients undergo fundoplication during first year of life. Other indications for anti-reflux surgery include recalcitrant anastomotic stenoses and apparent life-threatening episodes. In short term, fundoplication alleviates symptoms in most patients but recurrences are common occurring in at least one third of the patients. Patients with fundoplication wrap failure often require redo surgery, which may be complicated and associated with significant morbidity. A safe option in a subset of patients with failed anti-reflux surgery appears to be long-term medical treatment with proton pump inhibitors.
Subject: esophageal atresia
fundoplication
anti-reflux surgery
gastroesophageal reflux
anastomotic stricture
acute life-threatening events
long-gap atresia
PROTON PUMP INHIBITORS
CONGENITAL DIAPHRAGMATIC-HERNIA
GASTROESOPHAGEAL-REFLUX DISEASE
LAST 20 YEARS
NISSEN FUNDOPLICATION
TRACHEOESOPHAGEAL FISTULA
FOLLOW-UP
RESPIRATORY MORBIDITY
PULMONARY-FUNCTION
HIATAL-HERNIA
3123 Gynaecology and paediatrics
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