{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:32:37Z","timestamp":1780569157255,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":146,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Laparoscopic Nissen fundoplication (LNF) is the standard surgical treatment for gastroesophageal reflux disease (GERD) in patients with severe motor and intellectual disabilities (SMID). It is necessary to prevent the recurrence of GERD because it poses multiple clinical and surgical challenges for these patients. In Japan, the Endoscopic Surgical Skill Qualification System (ESSQS) has been established to ensure technical competency in laparoscopic surgery for pediatric patients. Our aim was to elucidate the risk factors for recurrence of GERD after LNF in pediatric patients with SMID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty patients with SMID who underwent LNF with gastrostomy for GERD at our institution between January 2009 and April 2022 were retrospectively investigated. Recurrence rate and risk factors were examined in univariate and multivariate analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GERD recurred in 5 of the 50 patients (10.0%). In univariate analysis, operation time was significantly longer in the recurrence group than in the non\u2010recurrence group (333 vs. 254\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). No operations in the recurrence group were performed by an ESSQS\u2010qualified surgeon (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.28). In multivariate analysis, operation time was an independent risk factor for recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Operation time was identified as a risk factor for recurrence of GERD after LNF in patients with SMID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence<\/jats:title>\n                    <jats:p>II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70085","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T21:52:24Z","timestamp":1748382744000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk Factors for Recurrence of Gastroesophageal Reflux Disease After Laparoscopic Nissen Fundoplication in Patients With Severe Motor and Intellectual Disabilities"],"prefix":"10.1111","volume":"18","author":[{"given":"Akinori","family":"Ichinose","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9877-8571","authenticated-orcid":false,"given":"Ken\u2010ichiro","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Takazawa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Sunouchi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Fujishiro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Graduate School of Medicine, the University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-200X.2003.01792.x"},{"key":"e_1_2_10_3_1","first-page":"265","article-title":"The Technique of Laparoscopic Nissen Fundoplication","volume":"2","author":"Hinder R. 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