Abstract
Objective
Gastroesophageal reflux disease (GERD) is cited by many to be a common cause of apparent
life-threatening events (ALTEs). However, there are few reports in the literature
regarding the surgical treatment of GERD to prevent a recurrent ALTE.
Methods
A retrospective review of infants undergoing fundoplication between 2000 and 2005
for the prevention of another ALTE was undertaken. Preoperative, operative, and postoperative
data as well as follow-up information were collected.
Results
During the study period, 81 patients underwent fundoplication after presenting with
an ALTE. All but 3 patients (96.3%) had been treated with antireflux medication. Moreover,
71 infants (87.7%) were taking antireflux medication at the time of their ALTE. A
significant number of infants (77.8%) were hospitalized with a second ALTE before
referral for fundoplication. After fundoplication, only 3 patients (3.7%) experienced
a recurrent ALTE during the follow-up period; 2 required a second fundoplication and
1 underwent pyloromyotomy. None of these 3 patients have experienced a recurrent ALTE
after the second operation. The median follow-up has been 1738 days.
Conclusion
Our data suggest that among patients who had an ALTE and are found to have GERD, fundoplication
appears to be an effective method for preventing recurrent ALTE.
Index words
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Article info
Footnotes
Papers presented at the 58th Annual Meeting of the Section on Surgery of the American Academy of Pediatrics.
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.