Gastro-oesophageal reflux and respiratory disorders treated by Hill's procedure

A retrospective review of 132 patients with respiratory disorders associated with gastrooesophageal reflux is presented. The patients were operated upon according to Hill's technique. In 66 infants and children, recurrent lung infection was the most frequent indication for surgery. The mean duration of respiratory symptoms was 17 months. In 66 adults, asthma was the most frequent indication for surgery. The mean duration of respiratory symptoms was 9.7 years. Suppression of reflux was obtained by operation in 95% of infants and children, with disappearance of respiratory disorders in 78.6% and clinical improvement of symptoms in 16.4%. Suppression of reflux was confirmed in 94% of adults, with disappearance of respiratory disorders in 36% and improvement of symptoms in 28%. The correlation between disappearance of reflux after surgery and cure of respiratory disorders in infants and children must be seen in the light of the natural history of lower oesophageal sphincter maturation. Nevertheless, surgery shortens the period of risk in life-threatening situations. In adults, one patient out of two benefited from operation. Failures were more frequent in asthma and there was no characteristic type of asthma associated with reflux.