Abstract | BACKGROUND/PURPOSE: METHODS: This was a retrospective review of 54 patients with NI (median, 7 years; range, 1-18 years) undergoing GP alone. The operative criteria included medically controllable or no reflux symptoms. The patients were divided into 2 groups based on the percentage of total esophageal time with a pH less than 4.0 (reflux index, or RI): group I (GI, n = 33), RI less than 5.0% (median age, 6 years; range, 2-15 years); group II (GII, n = 21), RI 5.0% or greater (median age, 10 years; range, 1-18 years). Data are expressed as medians and ranges. RESULTS: Nutritional management was successfully conducted after GP with or without the administration of lansoprazole, famotidine, or rikkunshito in all but 2 patients. One GI patient with alpha-thalassemia required fundoplication, and one GII patient with Cockayne syndrome required gastrojejunal tube feeding. The RI increased significantly in GI patients (2.1% [0%-4.8%] vs 4.5% [0.2%-11.4%], P = .004), whereas it decreased significantly in GII patients (11.2% [5.9%-41.6%] vs 9.8% [1.05-26.6%], P = .04). CONCLUSION:
Gastroesophageal reflux and related symptoms rarely deteriorate to require additional treatment after GP in patients with NI. Gastrostomy placement is a less invasive and effective procedure for improving the quality of life in those patients.
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Authors | Hisayoshi Kawahara, Yasuyuki Mitani, Keisuke Nose, Hiroshi Nakai, Akihiro Yoneda, Akio Kubota, Masahiro Fukuzawa |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 45
Issue 12
Pg. 2373-6
(Dec 2010)
ISSN: 1531-5037 [Electronic] United States |
PMID | 21129548
(Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2010 Elsevier Inc. All rights reserved. |
Chemical References |
- Anti-Ulcer Agents
- Drugs, Chinese Herbal
- liu-jun-zi-tang
- Famotidine
|
Topics |
- Adolescent
- Anti-Ulcer Agents
(therapeutic use)
- Child
- Child, Preschool
- Combined Modality Therapy
- Drugs, Chinese Herbal
(therapeutic use)
- Enteral Nutrition
- Famotidine
(therapeutic use)
- Female
- Fundoplication
- Gastroesophageal Reflux
(drug therapy, physiopathology, surgery)
- Gastrostomy
- Humans
- Hydrogen-Ion Concentration
- Infant
- Male
- Monitoring, Physiologic
- Nervous System Diseases
(complications)
- Retrospective Studies
- Time Factors
- Unnecessary Procedures
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