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Both open and laparoscopic Nissen fundoplication are associated with favorable short-term (<2 years) outcomes in children with complicated gastroesophageal reflux (GER). Investigators in the U.K. compared long-term outcomes (mean, 4 years) in a randomized trial of the two procedures in 44 children. Surgeries were performed by four surgeons with comparable experience in both procedures.
At follow-up, an investigator unaware of surgery allocation analyzed outcomes in 31 surviving children (mean age, 6 years; 81% with neurologic impairment). Procedures in two excluded patients were converted intraoperatively from laparoscopic to open surgery. Upper gastrointestinal contrast study or 24-hour pH probe was used to diagnose recurrence of GER in chi…