[The surgical treatment of gastroesophageal reflux (GER)]

From 1960 to 1990, a total of 2,476 instances of cardio-hiatal abnormalities were treated. The cause of the abnormality was achalasia (cardio-esophageal dilatation) in 2.244 instances, sliding hernias in 167 and hiatal hernias in 65. Only 213 patients underwent operations, 8,%. Gastroesophageal reflux in children has characteristics different from those of gastroesophageal reflux in adults. Knowledge of the forces that influence the closing mechanisms of the lower esophageal sphincter (LES) is the cornerstone for rational and logical intervention. The philosophy in pediatrics is that a child is a being in evolution and that the anomaly in children originates from a displaced healthy LES that has not had the opportunity to demonstrate its function because it is not in its proper place. An operation that helps to provide essential anatomic conditions immediately leads the LES to normal physiology. The A.A. discussed and presented in which cases the surgical procedure has to be taken.