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Steven L. Lee, MD; Roman M. Sydorak, MD; Vicki Y. Chiu, MS; Jin-Wen Hsu, PhD; Harry Applebaum, MD; Philip I. Haigh, MD

Arch Surg. 2008;143(9):873-876.

Hypothesis  Nissen fundoplication decreases the use of antireflux medications.

Design  Retrospective cohort study using discharge abstract data and pharmacy data.

Setting  Twelve regional Kaiser Permanente hospitals in southern California.

Patients  Three hundred forty-two patients underwent Nissen fundoplication.

Intervention  Nissen fundoplication.

Main Outcome Measure  Use of antireflux medications.

Results  The number of patients requiring antireflux medications decreased from 233 patients (68.1%) before Nissen fundoplication to 197 (57.6%) after Nissen fundoplication. Of the 233 patients, 176 (75.6%) were restarted on antireflux medications within 1 year after Nissen fundoplication. Use of antireflux medication decreased in neurologically healthy patients but was unchanged in neurologically impaired children.

Conclusions  Use of antireflux medication decreased after Nissen fundoplication. Neurologically healthy children showed the biggest decrease in antireflux medication use after Nissen fundoplication.

Author Affiliations: Division of Pediatric Surgery (Drs Lee, Sydorak, and Applebaum), Department of Surgery (Drs Lee, Sydorak, Hsu, Applebaum, and Haigh and Ms Chiu), Kaiser Permanente, Los Angeles Medical Center, Los Angeles, California.

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