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G194 A 15-Year Review of Open Versus Laparoscopic Boix-Ochoa Fundoplication

Identifieur interne : 000300 ( Main/Exploration ); précédent : 000299; suivant : 000301

G194 A 15-Year Review of Open Versus Laparoscopic Boix-Ochoa Fundoplication

Auteurs : Bn Ertansel [Royaume-Uni] ; Sd Adams [Royaume-Uni] ; Cj Healy [Royaume-Uni] ; Sc Blackburn [Royaume-Uni] ; Aae Van Der Avoirt [Royaume-Uni]

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RBID : ISTEX:0DD0EBBCEE52C9B7B38ABD4440FD279ADC7F6025

Abstract

Aim Boix-Ochoa Fundoplication is a established surgical treatment for gastroesophageal reflux disease. The surgical outcomes of this procedure have been compared to other types of Fundoplication in literature. There is no current publication comparing open to laparoscopic Boix-Ochoa Fundoplication. The aim of this study is to compare the outcomes of open versus laparoscopic Boix-Ochoa Fundoplication. Patient data categoriesLaparoscopicOpenP-ValueMales (%)53.386.70.046Neurological impairmenent (%)66.71000.014Mean age of surgery (years)7.68 (sd 5.22)7.32 (sd 5.37)-Gastrostomy performed (%)53.360.00.713Other procedure performed (e.g. pyloroplasty) (%)0.046.70.003Mean procedure time (mins)236 (sd 63)184 (sd 51)0.023Length of high dependency stay (days)2 (0–6)3 (1–6)0.006Length of hospital stay (days)4 (2–12)8 (6–43)0.003Length of follow up (years)1.57 (sd 1.9)6 (sd 3.7)0.001Clinical recurrence (%)7.728.60.163Methods A retrospective review was carried out including all Boix-Ochoa Fundoplications performed by a single surgeon in the same institution from 1995–2010. All available case notes from the laparoscopic group were analysed, these were matched to a similar number from the open group. Demographic, pre-operative, peri-operative and follow-up data were collated. Surgical outcomes were compared in terms of post-operative complications, length of stay, follow up period and clinical recurrence rates. Data were analysed in Microsoft Excel 2003 and SPSS 16.0. The groups were found to be non-parametric. Mann-Whitney U-test and Chi-squared distribution tests were applied. Statistical significance was taken to be p < 0.05. Results 71 procedures were recorded during the study period. 49 were open, 22 were laparoscopic. Notes were available for 15 patients in the laparoscopic group. These were matched with 15 patients from the open group. The laparoscopic group had more females and less neurologically impaired children. The length of stay post laparoscopy was halved compared to open surgery, but the mean operative time was more than 25% longer. The length of follow-up is longer in the open cohort due to the study design. Clinical recurrence rates were statistically similar between the two groups. Conclusion This is a small retrospective analysis of this procedure performed by one surgeon in a single centre. Boix-Ochoa Fundoplication appears to be equally effective when performed either open or laparoscopically. The duration of high dependency and hospital stay are significantly reduced with the laparoscopic procedure.

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DOI: 10.1136/archdischild-2013-304107.206


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<div type="abstract">Aim Boix-Ochoa Fundoplication is a established surgical treatment for gastroesophageal reflux disease. The surgical outcomes of this procedure have been compared to other types of Fundoplication in literature. There is no current publication comparing open to laparoscopic Boix-Ochoa Fundoplication. The aim of this study is to compare the outcomes of open versus laparoscopic Boix-Ochoa Fundoplication. Patient data categoriesLaparoscopicOpenP-ValueMales (%)53.386.70.046Neurological impairmenent (%)66.71000.014Mean age of surgery (years)7.68 (sd 5.22)7.32 (sd 5.37)-Gastrostomy performed (%)53.360.00.713Other procedure performed (e.g. pyloroplasty) (%)0.046.70.003Mean procedure time (mins)236 (sd 63)184 (sd 51)0.023Length of high dependency stay (days)2 (0–6)3 (1–6)0.006Length of hospital stay (days)4 (2–12)8 (6–43)0.003Length of follow up (years)1.57 (sd 1.9)6 (sd 3.7)0.001Clinical recurrence (%)7.728.60.163Methods A retrospective review was carried out including all Boix-Ochoa Fundoplications performed by a single surgeon in the same institution from 1995–2010. All available case notes from the laparoscopic group were analysed, these were matched to a similar number from the open group. Demographic, pre-operative, peri-operative and follow-up data were collated. Surgical outcomes were compared in terms of post-operative complications, length of stay, follow up period and clinical recurrence rates. Data were analysed in Microsoft Excel 2003 and SPSS 16.0. The groups were found to be non-parametric. Mann-Whitney U-test and Chi-squared distribution tests were applied. Statistical significance was taken to be p < 0.05. Results 71 procedures were recorded during the study period. 49 were open, 22 were laparoscopic. Notes were available for 15 patients in the laparoscopic group. These were matched with 15 patients from the open group. The laparoscopic group had more females and less neurologically impaired children. The length of stay post laparoscopy was halved compared to open surgery, but the mean operative time was more than 25% longer. The length of follow-up is longer in the open cohort due to the study design. Clinical recurrence rates were statistically similar between the two groups. Conclusion This is a small retrospective analysis of this procedure performed by one surgeon in a single centre. Boix-Ochoa Fundoplication appears to be equally effective when performed either open or laparoscopically. The duration of high dependency and hospital stay are significantly reduced with the laparoscopic procedure.</div>
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