From the Research
There is no direct causal relationship between fetal alcohol syndrome (FAS) and the need for Nissen fundoplication or Hartmann's procedure. Fetal alcohol syndrome results from maternal alcohol consumption during pregnancy and causes developmental issues, facial abnormalities, growth problems, and neurological impairments. Nissen fundoplication is a surgical procedure to treat severe gastroesophageal reflux disease (GERD) by wrapping the upper part of the stomach around the lower esophagus. Hartmann's procedure is a type of bowel surgery typically performed for complications of diverticulitis, bowel perforation, or certain cancers.
While patients with FAS may have various health complications that could potentially lead to conditions requiring these surgeries, FAS itself does not directly cause the need for either procedure. Any patient requiring these surgeries would need them based on their specific gastrointestinal or colorectal conditions, regardless of whether they have FAS. The treatment decisions should be based on the patient's current medical conditions rather than their FAS diagnosis.
Some studies have shown that laparoscopic Nissen fundoplication can be safely performed in neurologically impaired children, including those with FAS, with a low conversion rate and no surgical mortality 1. However, these studies do not establish a direct causal relationship between FAS and the need for Nissen fundoplication or Hartmann's procedure.
In terms of quality of life, laparoscopic Nissen fundoplication has been shown to improve overall quality of life in patients with GERD, including those with atypical symptoms 2. However, this does not imply a direct causal relationship between FAS and the need for Nissen fundoplication or Hartmann's procedure.
The diagnosis of FAS is based on specific criteria, including growth abnormalities, characteristic facial abnormalities, and structural or functional abnormalities of the central nervous system 3. While FAS can have serious, lifelong consequences for affected children and their families, it does not directly cause the need for Nissen fundoplication or Hartmann's procedure.
Key points to consider:
- FAS does not directly cause the need for Nissen fundoplication or Hartmann's procedure
- Treatment decisions should be based on the patient's current medical conditions, not their FAS diagnosis
- Laparoscopic Nissen fundoplication can be safely performed in neurologically impaired children, including those with FAS
- Quality of life can be improved with laparoscopic Nissen fundoplication in patients with GERD, but this does not imply a direct causal relationship between FAS and the need for surgery.