PURPOSE: Surgical control of gastroesophageal reflux (GER) is a challenging problem especially in neurologically impaired children and in acquired GER patients after caustic insult to the esophagus because of high failure rates of the classical antireflux procedures. A surgical technique has been designed to overcome this high relapse incidence. METHODS: During the past 75 months, 39 children between 4 months and 14 years of age underwent a gastric tube cardioplasty fashioned from the lesser curvature as the antireflux barrier. RESULTS: In all patients, the preoperative RI values of 72 to 10 (average, 32) fell to 0 to 5 (average, 2) after the described procedure, and, in the follow-up period of 2 to 75 months, the RI values did not deteriorate in any one of the cases. CONCLUSIONS: It is possible that a 6-cm antireflux barrier (HPZ) created from the lesser curvature of the stomach is enough to control GER at any age. Copyright 2003, Elsevier Science (USA). All rights reserved.
PURPOSE: Surgical control of gastroesophageal reflux (GER) is a challenging problem especially in neurologically impaired children and in acquired GER patients after caustic insult to the esophagus because of high failure rates of the classical antireflux procedures. A surgical technique has been designed to overcome this high relapse incidence. METHODS: During the past 75 months, 39 children between 4 months and 14 years of age underwent a gastric tube cardioplasty fashioned from the lesser curvature as the antireflux barrier. RESULTS: In all patients, the preoperative RI values of 72 to 10 (average, 32) fell to 0 to 5 (average, 2) after the described procedure, and, in the follow-up period of 2 to 75 months, the RI values did not deteriorate in any one of the cases. CONCLUSIONS: It is possible that a 6-cm antireflux barrier (HPZ) created from the lesser curvature of the stomach is enough to control GER at any age. Copyright 2003, Elsevier Science (USA). All rights reserved.