{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:58:07Z","timestamp":1779317887360,"version":"3.51.4"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2011,2,23]],"date-time":"2011-02-23T00:00:00Z","timestamp":1298419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Analyses of survival after fundoplication in childhood are often restricted to 30-day mortality, or to the neurologically impaired. The objective of this study was to report actuarial survival and variables associated with mortality for all children undergoing fundoplication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective observational study of fundoplication surgery by one surgeon; the endpoint was survival. Using a Cox proportional hazards model, gastrostomy, neurological status, tracheostomy, congenital cardiac disease, syndromic status, presence of congenital anomaly, other chronic disease, weight z-score at time of surgery, need for revisional fundoplication, use of laparoscopic surgery, gastric drainage procedures, age and sex were assessed for their influence on survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Two-hundred and thirty children underwent 255 fundoplications at a median age of 3\u00b76 years. Forty-six children (20\u00b70 per cent) died during a median follow-up of 2\u00b78 (range 0\u00b75\u201311\u00b72) years. Statistical modelling showed gastrostomy (relative risk of death 11\u00b704, P &amp;lt; 0\u00b7001), cerebral palsy (relative risk 6\u00b758, P = 0\u00b7021) and female sex (relative risk 2\u00b712, P = 0\u00b7015) to be associated with reduced survival. Revisional fundoplication was associated with improved survival (relative risk of death 0\u00b737, P = 0\u00b7037). Survivors had significantly higher weight z-scores (\u22121\u00b74 versus \u2212 2\u00b79 for those who died; P = 0\u00b7001). The 5-year survival rate after fundoplication for children with cerebral palsy and gastrostomy was 59 per cent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Survival of children following fundoplication is related principally to the presence of a gastrostomy and neurological status. Estimates of children's life expectancy should take account of the poorer survival of neurologically impaired children who undergo fundoplication, presumably due to the related co-morbidities that lead to a gastrostomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7415","type":"journal-article","created":{"date-parts":[[2011,2,25]],"date-time":"2011-02-25T15:51:00Z","timestamp":1298649060000},"page":"680-685","source":"Crossref","is-referenced-by-count":28,"title":["Survival of children following Nissen fundoplication"],"prefix":"10.1093","volume":"98","author":[{"given":"R","family":"Wockenforth","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, The Royal Victoria Infirmary, University of Newcastle, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C S","family":"Gillespie","sequence":"additional","affiliation":[{"name":"School of Mathematics & Statistics, University of Newcastle, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Jaffray","sequence":"additional","affiliation":[{"name":"Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,2,23]]},"reference":[{"key":"2021070906351317900_bib1","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1001\/archpediatrics.2009.103","article-title":"Variations between hospitals in antireflux procedures in children","volume":"163","author":"Goldin","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2021070906351317900_bib2","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1542\/peds.101.3.419","article-title":"Surgical treatment of gastroesophageal reflux in children: a combined hospital study of 7467 patients","volume":"101","author":"Fonkalsrud","year":"1998","journal-title":"Pediatrics"},{"key":"2021070906351317900_bib3","doi-asserted-by":"crossref","first-page":"b4411","DOI":"10.1136\/bmj.b4411","article-title":"Reflux related hospital admissions after fundoplication in children with neurological impairment: retrospective cohort study","volume":"339","author":"Srivastava","year":"2009","journal-title":"Br Med J"},{"key":"2021070906351317900_bib4","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1001\/archsurg.143.9.873","article-title":"Long-term antireflux medication use following pediatric Nissen fundoplication","volume":"143","author":"Lee","year":"2008","journal-title":"Arch Surg"},{"key":"2021070906351317900_bib5","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1097\/00000658-199206000-00012","article-title":"Nissen fundoplication in children with profound neurologic disability. 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