Purpose: To assess role of intraoperative endoscopy in antireflux procedure regard to detection of gastroesophageal junction and assessment of tightness of wrap. Background: Due to immaturity of the lower esophageal sphincter, which results in the retrograde passage of stomach contents into the oesophagus, gastroesophageal reflux disease is the most prevalent gastroenterologic problem requiring referral to a paediatric gastroenterologist during infancy. Patients and methods: This prospective study included 30 patient of pediatric Age less than 18 years old with GERD resistant to conservative treatment. This study was performed at Benha university hospital and Cairo University Specialized Pediatric Hospital at period from October, 2020 till October, 2022. The procedure was authorised by the medical school's ethics committee. Written informed permission was acquired from the parents of all patients; all patients after informed consent were subjected to laparoscopic Nissen fundoplication. During treatment procedure, endoscopy had been used to locate gastroesophageal junction (GEJ) and to assess tightness of performed valve. Results: there is significant decrease in early post-operative complication rate as early dysphagia 23.3%, early vomiting 10%, no cases of post-operative bleeding or post-operative pneumothorax or esophageal perforation, operative time was seen to be substantially longer in our procedure, the incidence of late postoperative dysphagia and gas bloat syndrome was statistically lower in current study. Conclusions: Endoscopy during surgery enables the surgeon to check the wrap geometry, decreasing the rate of postoperative recurrence of GERD symptoms, post-operative dysphagia and decrease risk of esophageal perforation however prolongation operative time is the main side effect. |
