Does Nissen Fundoplication Decrease Reflux-Related Problems Including Respiratory Illness in Children With Neurological Impairment?

To the Editor In the study by Barnhart et al,¹ no difference was identified in reflux-related hospitalizations in the year following gastrostomy tube placement between groups with or without Nissen fundoplication in infants with neurological impairment (NI). Barnhart et al indicated potentially important confounders unknown in this study, such as severity of NI and intolerance of gastric feedings. In going forward, other details relevant to this group of children will need to be considered.