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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- National Institutes of Health Consensus Development Conference on Infantile apnea and home monitoring.Pediatrics. 1987; 79: 292-299
- Gastroesophageal reflux causing respiratory distress and apnea in newborn infants.J Pediatr. 1979; 95: 763-768
- Apnea associated with regurgitation in infants.J Pediatr. 1985; 106: 625-629
- Awake apnea associated with gastroesophageal reflux: a specific clinical syndrome.J Pediatr. 1984; 104: 200-205
- Gastroesophageal reflux associated with respiratory abnormalities during sleep.J Pediatr Gastroenterol Nutr. 1989; 9: 28-33
- Factors involved in the pathogenesis of unexpected near miss events of infants (ALTE).Acta Pediatr Hung. 1990; 30: 435-437
- Gastroesophageal reflux in infants with a history of near-miss sudden infant death.J Pediatr Gastroenterol Nutr. 1991; 12: 319-323
- Etiology of 19 infants with apparent life-threatening events: relationship between apnea and esophageal dysfunction.Acta Paediatr Jpn. 1993; 35: 306-310
- Otolaryngic manifestations in children presenting with apparent life-threatening events.Otolaryngol Head Neck Surg. 1997; 116: 575-579
- Associated and prognosis in apparent life threatening events.J Pediatr (Rio J). 1999; 75: 55-58
- Apparent life threatening events in infants presenting to an emergency department.Emerg Med J. 2002; 19: 11-16
- Causes of apparent life threatening events in infants: a systematic review.Arch Dis Child. 2004; 89: 1043-1048
- Apparent life-threatening event: a review.Pediatr Clin North Am. 2005; 52: 1127-1146
- Evaluation and management of apparent life-threatening events in children.Am Fam Physician. 2005; 71: 2301-2308
- Recommended clinical evaluation of infants with an apparent life-threatening event. Consensus document of the European Society for the Study and Prevention of Infant Death, 2003.Eur J Pediatr. 2004; 163: 108-115
- Indications for laparoscopic antireflux procedures in children.Semin Laparosc Surg. 2002; 9: 139-145
- Epidemiology of apparent life threatening events.Arch Dis Child. 2005; 90: 297-300
- Outcome of idiopathic apparent life-threatening events: infant and mother perspectives.Pediatr Pulmonol. 1999; 28: 47-52
- Reflux associated apnea in infants: evidence for a laryngeal chemoreflex.Am J Med. 1997; 103: 120S-124S
- Reflex laryngospasm induced by stimulation of distal esophageal afferents.Laryngoscope. 1994; 104: 209-214
- Gastroesophageal reflux causing respiratory distress and apnea in newborn infants.J Pediatr. 1979; 95: 763-768
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.
