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Fundoplication Alternative
Question
Have you heard of an Endo-Cinch as an alternative for a Nissen Fundoplication?
Answer of our experts
The procedure is done with an endoscope. You either suture the inside of the esophagus tighter or cauterize it so it burns and then scars tighter. It is being done on adults. We have no long-term data, but my understanding is that they are not expected to last as long as a regular Nissen. I would think they would present fewer problems with bloating, etc., although vomiting would still be impossible
CP/TK 7-13-10
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Recommendation(s)
Reflux
R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.
