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Current thinking on the role of surgery in gastroesophageal reflux

D G Johnson

    Pediatric Clinics of North America
    |October 1, 1985
    PubMed

    Insights

    Gastroesophageal reflux in children often resolves naturally. However, severe cases may require surgery when medical treatments fail, addressing complications like lung infections and apnea.

    Area of Science:

    • Pediatric Gastroenterology
    • Pediatric Surgery

    Background:

    • Gastroesophageal reflux is a common condition in infants and children.
    • While often benign, reflux can lead to severe complications in a subset of patients.

    Purpose of the Study:

    • To outline the indications for surgical intervention in pediatric gastroesophageal reflux.
    • To discuss the surgical options and their associated outcomes.

    Main Methods:

    • Review of established surgical indications for refractory gastroesophageal reflux in pediatric patients.
    • Discussion of surgical techniques, including fundoplication, and their respective risks and benefits.

    Main Results:

    • Surgical intervention is considered when medical management fails to resolve complications such as recurrent pulmonary infections, obstructive apnea, nutritional wasting, or esophageal injury.
    • Complete fundoplication offers robust reflux control but carries a higher risk of complications.

    Conclusions:

    • Surgical management of pediatric gastroesophageal reflux is reserved for specific, severe cases with established cause-effect relationships.
    • The choice of surgical procedure should be tailored to surgeon expertise, balancing efficacy with potential side effects.

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