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Srivastava R. et al. show how fundoplication procedure performed on
cerebro-pathic children with gastro-esophageal reflux disease (GERD)
appears to reduce the number of hospital readmissions related to GERD,
aspiration pneumonia, and mechanical ventilation during the first year
post surgery. A similar reduction was not observed in the hospitalization
due to asthma and pneumonia.
In our experience based on 24 cerebro-pathic children (9 females and
15 males, mean age 13 years and 2 months with range 5-29 years) who
underwent fundoplication surgery we found a 69% reduction in hospital
readmission for pneumonia (without distinguishing between aspiration
pneumonia or pneumonitis) over a 26 months period after surgery (range 7-
60 months). Only 1 patient (4%) had a relapse of GERD detected by
Furthermore, we measured (using two tests, GERD HRQOL-test by Velanovich
and WHOQOL-BREF-test) an improvement in both quality of life (QoL) of the
patients (reduction in the recurrence of coughing, apnea, cianosis, crying
spells while eating in over 83% of our sample), and QoL of parents/care-
givers (an improvement in 77% of the patients families). We would like to
emphasize also that 94% of the parents were completely satisfied with the
outcome of the fundoplication procedure.
We believe that the QoL of the children patients and of their
parents/care-givers rappresent factors which should be taken into
consideration in the general evaluation of the effectiveness of
therapeutic procedures when treating these young patients.
No competing interests
31 December 2009
Alessandro Ventura, Jurgen Schleef
Institute of Child Health, IRCCS Burlo Garofolo, University of Trieste, Trieste, Italy (34100)