To Nissen or not to Nissen.

Nissen's fundoplication is associated with a high morbidity rate in children. The symptoms are expressed as dysphagia, bloating, diarrhea, and neurotic behavioral changes. On the basis of our own experience, Nissen's fundoplication is not the treatment of choice in children. It is indicated only in cases where a total absence of reflux is tolerable (reflux followed by episodes of apnea, children with cerebral damage, etc.).