Treatment of gastroesophageal reflux in children by Thal fundoplication

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Gastroesophageal reflux (GER) is a common condition in children.
• Medical therapy for GER may fail or be inappropriate for some patients.
• Surgical intervention, such as fundoplication, is considered when conservative treatments are insufficient.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of the Thal anterior fundoplication in children with refractory gastroesophageal reflux.
• To assess the rates of reflux recurrence and persistent symptoms after Thal fundoplication.
• To compare the outcomes of Thal fundoplication with other surgical techniques for GER in pediatric populations.

Main Methods:

• Retrospective review of 362 children who underwent Thal anterior fundoplication.
• Evaluation of long-term outcomes, including relief of reflux and associated symptoms.
• Analysis of reoperation rates, symptom recurrence, and complications.

Main Results:

• 90% of 335 followed patients achieved satisfactory initial results after Thal fundoplication.
• 5% of patients required reoperation for reflux recurrence or hiatus hernia within 5 months.
• 4.5% of patients had persistent symptoms not attributable to reflux, indicating incorrect initial symptom attribution.

Conclusions:

• Thal anterior fundoplication is an effective surgical option for pediatric gastroesophageal reflux with a high success rate.
• The procedure demonstrates favorable long-term outcomes and a low rate of serious complications.
• Outcomes compare favorably to the Nissen fundoplication, supporting its use in selected pediatric cases.