J Korean Assoc Pediatr Surg.  2000 Dec;6(2):100-105. 10.13029/jkaps.2000.6.2.100.

Surgical Management of Gastroesophageal Reflux Disease

Affiliations
  • 1Division of Pediatric Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
  • 2Department of Pediatrics, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.

Abstract

Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two hiatal hernia and one had history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting (81.8%), followed by recurrent respiratory infections (72.7%) and failure to thrive (72.7%). The most common diagnostic tool was 24 hour esophageal pH study, which showed a pH less than 4 for more than 10% of the total recorded time in 6 among 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There were one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy be considered in a patient with neurological impairment.

Keyword

Gastroesophageal reflux; Fundoplication; Gastrostomy

MeSH Terms

Child
Deglutition
Esophageal Atresia
Failure to Thrive
Follow-Up Studies
Fundoplication
Gastroesophageal Reflux*
Gastrostomy
Hernia, Hiatal
Humans
Hydrogen-Ion Concentration
Quality of Life
Recurrence
Respiratory Tract Infections
Vomiting
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