Nicola Zampieri* and Francesco Saverio Camoglio
Department of Pediatric Surgery, University of Verona, ItalyFulltext PDF
Introduction: Gastroesophageal Reflux (GER) is a common problem in infants and children. Fundoplication is the surgical treatment of GERD and consists of a partial (less than 360 degrees) or complete wrap or plication (i.e. folding) of the fundus of the stomach around the esophagus. This surgery can be performed using either traditional open techniques or minimally invasive techniques. The purpose of this communication is to explain the most popular techniques and to report the clinical and surgical outcomes in the pediatric population.Materials and
Methods: A review of the current literature was performed focusing on paper about clinical indications and surgical treatment of GER in pediatric age. Most popular techniques used were compared after showing steps.Results: At present many different fundoplication techniques are used: patients are selected for surgery only if their medical treatment failed and if they show esophagitis and stricture or Barrett esophagus. Other indications to surgery are pulmonary symptoms, specifically asthma with persistent symptoms and reflux despite medical management and recurrent pneumonia associated with GER.Conclusion: At present there is not the gold standard technique but in the different cases reported in literature it is possible to identify some elements that may represent a “gold standard” for any type of fundoplication: crural closure, well mobilized esophagus, floppy wrap, and the use of nonabsorbable sutures.
Children; Laparoscopic treatment; Gastroesophageal reflux
Zampieri N, Camoglio FS. Laparoscopic Treatment for Gastroesophageal Reflux in Children: Open Spects. Clin Surg. 2017; 2: 1763.