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Richard C. Pennell, MD; J. Eugene Lewis, MD; Thomas V. Cradock, MD; Richard K. Danis, MD; Donald L. Kaminski, MD

Arch Surg. 1984;119(5):553-557.

Abstract
• To evaluate response to fundoplication, clinical results for 66 consecutive pediatric patients operated on for gastroesophageal reflux were retrospectively reviewed. Indications for operation were gastroesophageal reflux with apnea, repeated emesis, recurrent pneumonia, failure to thrive, stricture, and esophagitis. All patients had preoperative documentation of significant gastroesophageal reflux by either cinefluoroscopic reflux esophagogram or reflux nuclear scan. Fundoplication was effective in 56 (87%) of 64 patients. None of the patients considered to be operative failures had persistent gastroesophageal reflux. Operative failures occurred primarily in patients with gastroesophageal reflux and apnea or recurrent pneumonia. More advanced diagnostic tests, such as pH monitoring, may help to select patients whose symptoms of apnea and recurrent pneumonia are truly due to reflux. Gastroesophageal reflux produces significant morbidity in pediatric patients and is well treated operatively by fundoplication.

(Arch Surg 1984;119:553-557)

Author Affiliations
From the Department of Surgery, St Louis University (Drs Pennell and Kaminski), and Cardinal Glennon Memorial Hospital for Children, St Louis (Drs Lewis, Cradock, and Danis).

Footnotes
Accepted for publication Jan 6, 1984.

Read before the 91st annual meeting of the Western Surgical Association, Monterey, Calif, Nov 15, 1983.

Reprint requests to Department of Surgery, St Louis University Hospital, 1325 S Grand Blvd, St Louis, MO 63104 (Dr Kaminski).

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