کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4155130 1273737 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Fundoplication and gastrostomy versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: A systematic review and meta-analysis
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
پیش نمایش صفحه اول مقاله
Fundoplication and gastrostomy versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: A systematic review and meta-analysis
چکیده انگلیسی

BackgroundChildren with neurologic impairment often fail medical management of gastroesophageal reflux and proceed to fundoplication and gastrostomy (FG) or percutaneous gastrojejunostomy (GJ). Current guidelines do not recommend one treatment over the other, and there is ongoing uncertainty regarding clinical management.MethodsWe conducted a structured search of Medline, Embase, trial registries, and the gray literature. We included studies that compared outcomes for FG and GJ in children with neurologic impairment.ResultsWe identified 556 children from three retrospective studies who underwent FG (n = 431) or GJ (n = 125). There were no differences in rates of pneumonia (17% vs 19%, p = 0.74) or mortality (13% vs 14%, p = 0.76). Few deaths were due to procedural complications (1%) or reflux (2%). There was a trend towards more major complications with FG (29%) compared to GJ (12%) (risk ratio = 1.70, 0.85–3.41, p = 0.14). Minor complications were more common with GJ (70%) than FG (45%), but this difference was also not statistically significant (risk ratio = 0.38, 0.05–3.07, p = 0.36). No studies reported quality of life using validated measures.ConclusionsThe quality of the evidence for outcomes of FG versus GJ is very low. Large comparative studies are needed to determine which approach is associated with the best quality-of-life outcomes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 50, Issue 5, May 2015, Pages 707–714
نویسندگان
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