Surgical treatment of gastroesophageal reflux in children. Results of Nissen's fundoplication in 100 children

L. L. Leape and M. L. Ramenofsky

One hundred children underwent Nissen's fundoplication for complications of gastroesophageal reflux. Indications for fundoplication included refractory pneumonia, apneic spells, intractable vomiting, failure to thrive, esophagitis, esophageal stricture, and Sandifer's syndrome. Except for those with life-threatening complications, fundoplication was performed only in those who had failure with a strict medical antireflux regimen. Four patients were not helped by operation or had a recurrence of symptoms. Of these, three with refractory pneumonia were judged to be failures of selection since reflux was absent postoperatively. The fourth had massive reflux and recurrent vomiting. Eight other patients had radiologic evidence of reflux postoperatively. Six of these were asymptomatic and two had minor symptoms. There was one death and 11 postoperative complications.