Long-term antireflux medication use following pediatric Nissen fundoplication.

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.