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Surgery in children with gastroesophageal reflux and respiratory symptoms
Insights
Antireflux surgery effectively controlled vomiting and improved respiratory symptoms in children. However, complete respiratory symptom relief was less likely in those with central nervous system disorders, suggesting other causes for persistent issues.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pulmonology
Background:
- Gastroesophageal reflux (GER) is a common condition in children, often associated with respiratory symptoms.
- Antireflux surgery is a treatment option for severe cases, but its impact on respiratory symptoms requires further investigation.
- Associated comorbidities can influence surgical outcomes in pediatric patients.
Purpose of the Study:
- To evaluate the effectiveness of antireflux surgery in managing both gastroesophageal reflux and associated respiratory symptoms in children.
- To compare outcomes in children with and without respiratory symptoms who underwent antireflux surgery.
- To identify factors influencing the resolution of respiratory symptoms after surgery.
Main Methods:
- Retrospective review of a seven-year surgical experience in 63 children undergoing antireflux operations for GER and respiratory symptoms.
- Comparison with a control group of 72 children who had antireflux surgery for GER without respiratory symptoms.
- Analysis of age, sex, associated disorders (central nervous system, pharyngeal, esophageal), and vomiting control.
Main Results:
- Vomiting was successfully controlled in 96% of patients.
- 92% of children experienced at least partial relief of respiratory symptoms postoperatively.
- Complete respiratory symptom resolution was significantly more frequent in patients without major associated disorders (97% vs. 59%, P = 0.0009).
- Central nervous system disorders were prevalent in children with incomplete respiratory symptom resolution.
Conclusions:
- Antireflux surgery is effective in controlling vomiting and improving respiratory symptoms in a majority of children with GER.
- The presence of major associated disorders, particularly central nervous system issues, is linked to less favorable respiratory outcomes.
- Respiratory difficulties in some children may stem from causes independent of GER, necessitating comprehensive diagnostic evaluation.
Abstract:
We reviewed our seven-year experience in 63 children with an operation to control gastroesophageal reflux and respiratory symptoms. The age at operation, sex, major associated disorders, and control of vomiting in this group of children were compared with another group of 72 children without respiratory symptoms who also had an antireflux operation during the same period. Associated central nervous system, pharyngeal, or esophageal disorders were common in both groups. Vomiting was controlled in 96% of patients. Fifty-six of 61 (92%) children had at least partial relief of respiratory symptoms postoperatively. The complete relief of these symptoms was more likely in patients without major associated disorders (97% vs 59% P = 0.0009). Central nervous system disorders were present in most children with incomplete resolution of respiratory symptoms. It appears that a significant number of affected infants and children may have respiratory difficulties unrelated to the presence of GER.