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[Surgical treatment of gastroesophageal reflux (hiatal hernia) in pediatric age]
Insights
Nissen fundoplication effectively treated gastroesophageal reflux in 49 pediatric patients. The surgical procedure resolved reflux symptoms, with a low complication rate, demonstrating its efficacy in pediatric care.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Reflux Management
Context:
- Retrospective study of 49 pediatric patients with gastroesophageal reflux.
- Four-year experience at Hospital del Niño, IMAN.
- Standardized treatment protocol including diagnostic tests and surgical intervention.
Purpose:
- To evaluate the efficacy and safety of Nissen fundoplication for pediatric gastroesophageal reflux.
- To assess outcomes in patients with associated esophageal stenosis.
Summary:
- All 49 patients underwent Nissen fundoplication; 80% had preoperative esophageal stenosis.
- Gastrostomy was performed in cases with stenosis.
- Complete resolution of gastroesophageal reflux was achieved in all patients.
- One patient died postoperatively; one experienced gastric perforation on day nine.
Impact:
- Nissen fundoplication is highly effective in preventing gastroesophageal reflux in children.
- Highlights the significant prevalence of esophageal stenosis in this pediatric cohort.
- Suggests a high volume of pediatric reflux cases at the institution compared to other series.
Abstract:
Forty nine pediatric patients with gastroesophageal reflux were studied retrospectively; this is a 4 years experience of Hospital del Niño, IMAN. All of them were treated in the same manner, which included barium gastrointestinal series, esophagoscopy, gastric secretion test. Nissen's funduplication was performed in all of them, plus gastrostomy in those cases having esophageal stenosis. Preoperatively, eight out of every ten patients had stenosis. From the entire series, one patient died. All of them were relieved from their gastroesophageal reflux. By the ninth day following operation, one patient suffered a gastric perforation. The authors make special considerations concerning the high number of cases per year, as compared with other series. Nissen's funduplication proved very efficient to prevent gastroesophageal reflux.