Surgical management of reflux strictures of the esophagus in childhood.

Abstract:

:The etiology of gastroesophageal reflux (GER) in infancy is related to developmental factors, and there is a high incidence of associated conditions such as neurologic syndromes and esophageal atresia (60%). This is different from the situation in adults. Experience with 18 consecutive children with peptic esophageal strictures is reviewed to determine if conservative surgical management is effective. Eighteen children 14 months to 13 years (mean 6.3 years) of age took an average of 3.5 years from the time of onset of symptoms of GER to develop tight strictures diagnosed by esophagography and esophagoscopy. The incidence of stricture in patients with GER was approximately 15%. Preoperative dilation or direct surgical management prior to correction of reflux is ineffective. All 18 children were managed by intraoperative dilatation, Nissen fundoplication, and guided dilatation after operation. More aggressive surgical procedures were not required nor were associated operations such as pyloroplasty; they are rarely necessary. An average three-year follow-up indicates that this conservative surgical approach is effective in the management of peptic esophageal strictures in childhood with relief of symptoms and gratifying improvement in growth.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

O'Neill JA Jr,Betts J,Ziegler MM,Schnaufer L,Bishop HC,Templeton JM

doi

10.1097/00000658-198210000-00008

subject

Has Abstract

pub_date

1982-10-01 00:00:00

pages

453-60

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

196

pub_type

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