Abstract
The authors present their long-term experience with surgical treatment of gastrooesophageal reflux (GER) in childhood. During the period between 1984 - 1993 they operated 243 children from neonatal age to 18 years.
In 241 patients Nissen fundoplication was performed, once Thai's operation and once a modification of BoixOchoy's operation. Of 243 children 18 children (7.4 %) died without any association with the operation, 5 children were re-operated on account of ileus, 5 developed a dehiscence of the surgical wound, 4 a paraoesophageal hernia and 2 a relapse of the reflux.
The most frequent indication for surgery were relapsing bronchopneumonias 71 (29 %), apnoe 44 (18 %), impaired nutrition and growth 43 (17 %), asthma bronchiale 38 (15%), oesophageal stricture 20 (8%), suffocating laryngitis 14 (6 %) and incoordinated deglutition (5 %). Two hundred and nine patients attended check-up examinations 3 - 13 years after surgery. 174 children (83 %) do not have clinical manifestations of GER and no difficulties with swallowing. 27 children (13 %) report marked improvement of the clinical manifestations of GER or slight difficulties when swallowing.
Nissen fundoplication was a success in 96 % children with GER. The authors recommend Nissen fundoplication for the surgical treatment of GER in child age because the long-term results with this method are favourable.