Esophagogastric Dissociation for GERD in Severe Neurodisability
With Dr. Ian Glenn · hosted by Dr. Todd Ponsky · StayCurrentMD
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
More about GERD
same diagnosisVideo
Esophagogastric Dissociation for GERD in Severe Neurodisability
Dr. Todd Ponsky · 2 min · Published Oct 2016
Video
Top Themes From The Stay Current App
Published Sep 2020
Video
QUAD #27 - Multidisciplinary - How Do Teams Enhance Outcomes by the CCHMC ADEC Team
CCHMC Pediatric Surgery · 10 min · Published Apr 2025
Podcast
Pediatric Gastroesophageal Reflux Disease
81 min · Published Aug 2018
Video
Management of Retained Central Venous Catheters
Dr. Todd Ponsky · 3 min · Published Apr 2019
Video
Do we need Bowel Prep
1 min · Published Apr 2019
Video
Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...
19 min · Published Nov 2018
Video
Retained Central Venous Catheters
3 min · Published Oct 2018
Video
Retained Central Venous Catheters
3 min · Published Oct 2018
Video
Posterior Tracheopexy For Severe Tracheomalacia
Dr. Todd Ponsky · 2 min · Published Feb 2018
Video
Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
56 s · Published May 2026
Video
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
Video
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
Video
Pooling Patients to Study Rare Pediatric Tumors: An Introduction to PSORC
56 s · Published May 2026
Video
The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
44 s · Published May 2026
Video
Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
1 min · Published May 2026
What the experts said
A multi-center study will probably be needed to really understand the difference between these procedures.
The study did not look at complication rates such as leaks and strictures, which are the main concern for why most surgeons don't perform esophagogastric dissociation.
Esophagogastric dissociation is a much bigger surgery than Nissen fundoplication.
Esophagogastric dissociation was historically thought of as a last resort operation when Nissen fundoplication won't work.
Esophagogastric dissociation is now being suggested as an upfront primary operation for a small subset of patients with severe neurologic impairment.
The study compared patients with severe GERD and neurologic disability, half undergoing esophagogastric dissociation and half undergoing laparoscopic Nissen.
Primary outcome was operative failure, defined as either recurrence of preoperative reflux symptoms or requirement of additional anti-reflux surgery.
There was a 4% failure rate in the esophagogastric dissociation group and a 21% failure rate in the Nissen group.
The difference in failure rates between esophagogastric dissociation (4%) and Nissen (21%) was not statistically significant.
17% of patients in the esophagogastric dissociation group continued to require anti-reflux medications after surgery, compared to 54% in the Nissen group.
The difference in continued requirement for anti-reflux medications (17% vs 54%) was statistically significant.
Caregiver-evaluated quality of life and symptom scores were the same between the two groups with no statistically significant difference.
The lack of statistical significance in failure rates could potentially be a type 2 error where there was actually a difference but the sample size was too small to detect it.
The study examined perioperative factors including time in the OR, length of hospital stay, need for ICU stay, and time to full feeds, with statistically significant differences following expected trends.
The study did not report on leaks, strictures, or long-term requirement for additional surgeries other than anti-reflux operations.