Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study
Gastrostomy placement is crucial in neurologically impaired (NI) children to ensure an adequate food intake and a safe route for drugs administration and to reduce the risk of primary aspiration. NI patents are more prone to gastroesophageal reflux. The association with fundoplication is deemed to r...
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MDPI AG
2021-01-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/1/22 |
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| author | Elisa Zambaiti Calogero Virgone Silvia Bisoffi Roberta Stefanizzi Francesco Fascetti Leon Piergiorgio Gamba |
| author_facet | Elisa Zambaiti Calogero Virgone Silvia Bisoffi Roberta Stefanizzi Francesco Fascetti Leon Piergiorgio Gamba |
| author_sort | Elisa Zambaiti |
| collection | DOAJ |
| description | Gastrostomy placement is crucial in neurologically impaired (NI) children to ensure an adequate food intake and a safe route for drugs administration and to reduce the risk of primary aspiration. NI patents are more prone to gastroesophageal reflux. The association with fundoplication is deemed to reduce reflux-related respiratory complications. However, long-term benefits of this approach are not clear. We therefore aimed to compare long-term reflux-related respiratory complications of gastrostomy only (GO) to gastrostomy with fundoplication (GF). We retrospectively reviewed 145 consecutive NI children managed from 2008 to 2018. As long-term outcomes, we analyzed number and length of hospital admissions (Reflux-Related-Hospitalization, RRH) and emergency department accesses (Reflux-Related-Accesses, RRA) due to respiratory problems. Results were analyzed with appropriate statistical method. Median age at referral and at gastrostomy placement were 2.2 and 3.4 years (SD 5.6), respectively. Median follow-up was four years (range 1–12). Anti-reflux procedures were performed in 26/145 patients (18%); tracheotomy in 23/145 (16%). RRH following surgery showed lower number of admissions/year (0.32 vs. 1 for GO vs. GF, <i>p</i> < 0.005) and days hospitalization/year (3 vs. 13, <i>p</i> = 0.08) in GO compared to GF; RRA was similar (0.60 vs. 0.65, <i>p</i> = 0.43). Gastrostomy placement alone appeared not to be inferior to gastrostomy plus fundoplication with respect to long-term respiratory-related outcomes for NI children in our center. |
| first_indexed | 2024-03-10T13:30:18Z |
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| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T13:30:18Z |
| publishDate | 2021-01-01 |
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| record_format | Article |
| series | Children |
| spelling | doaj.art-bb5da9fa89aa438a99e5f227f6e3acfa2023-11-21T08:06:29ZengMDPI AGChildren2227-90672021-01-01812210.3390/children8010022Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort StudyElisa Zambaiti0Calogero Virgone1Silvia Bisoffi2Roberta Stefanizzi3Francesco Fascetti Leon4Piergiorgio Gamba5Division of Pediatric Surgery, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyDivision of Pediatric Surgery, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyDivision of Pediatric Surgery, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyDivision of Pediatrics, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyDivision of Pediatric Surgery, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyDivision of Pediatric Surgery, Department Women’s and Children’s Health, University Hospital of Padua, 35121 Padua, ItalyGastrostomy placement is crucial in neurologically impaired (NI) children to ensure an adequate food intake and a safe route for drugs administration and to reduce the risk of primary aspiration. NI patents are more prone to gastroesophageal reflux. The association with fundoplication is deemed to reduce reflux-related respiratory complications. However, long-term benefits of this approach are not clear. We therefore aimed to compare long-term reflux-related respiratory complications of gastrostomy only (GO) to gastrostomy with fundoplication (GF). We retrospectively reviewed 145 consecutive NI children managed from 2008 to 2018. As long-term outcomes, we analyzed number and length of hospital admissions (Reflux-Related-Hospitalization, RRH) and emergency department accesses (Reflux-Related-Accesses, RRA) due to respiratory problems. Results were analyzed with appropriate statistical method. Median age at referral and at gastrostomy placement were 2.2 and 3.4 years (SD 5.6), respectively. Median follow-up was four years (range 1–12). Anti-reflux procedures were performed in 26/145 patients (18%); tracheotomy in 23/145 (16%). RRH following surgery showed lower number of admissions/year (0.32 vs. 1 for GO vs. GF, <i>p</i> < 0.005) and days hospitalization/year (3 vs. 13, <i>p</i> = 0.08) in GO compared to GF; RRA was similar (0.60 vs. 0.65, <i>p</i> = 0.43). Gastrostomy placement alone appeared not to be inferior to gastrostomy plus fundoplication with respect to long-term respiratory-related outcomes for NI children in our center.https://www.mdpi.com/2227-9067/8/1/22gastroesophageal refluxneurological impairmentreflux-related complications |
| spellingShingle | Elisa Zambaiti Calogero Virgone Silvia Bisoffi Roberta Stefanizzi Francesco Fascetti Leon Piergiorgio Gamba Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study Children gastroesophageal reflux neurological impairment reflux-related complications |
| title | Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study |
| title_full | Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study |
| title_fullStr | Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study |
| title_full_unstemmed | Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study |
| title_short | Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study |
| title_sort | long term analysis of respiratory related complications following gastrostomy placement with or without fundoplication in neurologically impaired children a retrospective cohort study |
| topic | gastroesophageal reflux neurological impairment reflux-related complications |
| url | https://www.mdpi.com/2227-9067/8/1/22 |
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