[Gastroesophageal reflux in children. Surgical treatment by the Nissen's technique].

BACKGROUND

To analyse the results of Nissen's fundoplication in the treatment of gastro-esophageal reflux (GER) in children.

MATERIAL AND METHODS

A retrospective study was undertaken in 185 children with GER, diagnosed through upper gastrointestinal (GI) tract barium examination, and admitted at Hospital Infantil Joana de Gusmão-Florianópolis, SC, Brazil, from February 1981 to June 1989. From the charts the following data were reviewed: age, sex, clinical picture, subsidiary tests, surgical indications, surgical treatment by Nissen's fundoplication, pre and transoperative treatment, post operative complications and results classified as good (no reflux), bad (relapse), unknow (no follow-up) and deaths.

RESULTS

The age ranged from 30 days to seven years and sex incidence was predominant in males (2:1). The main clinical manifestation were vomits (85.40%), respiratory distress (64.32%) and malnutrition (55.13%). Upper GI tract examination revealed isolated GER (40.00%), associated to hiatal hernia (18.91%) and complicated with esophagitis (29.18%) and peptic stenosis (11.89%). In the transoperative period there was terminal esophagus perforation in one case. The main postoperative complications were gas bloat syndrome (7.02%) and edema of the terminal esophagus (5.94%). The result was good in 159 children (85.94%), bad in 7 (3.78%) and unknown in 11 (5.94%). There were 8 deaths (4.32%): 1 (0.54%) related to the disease, 1 (0.54%) to the surgery and 6 (3.24%) related to medical causes.

CONCLUSIONS

Based on these results, Nissen's fundoplication is an adequated operation for treatment of children with GER.