Retroesophageal Hiatal Plasty and Gastropexy in the Treatment of Gastroesophageal Reflux with or Without Hiatus Hernia in Childhood

Abstract

Not every patient with gastroesophageal reflux requires treatment, not to mention surgical treatment. According to the American pediatric surgeon Lucian Leape (1979), closure of the cardia is incomplete in 25%–50% of all infants. Roughly two-thirds of these infants never show symptoms and only one-third become symptomatic. In approximately 75% of the symptomatic infants, symptoms are mild and these children usually undergo treatment by the pediatric practitioner, whereas clinical treatment is necessary in the remaining 25% where most of them, namely 90%, are cured conservatively. Only 10% of this small remaining group require surgery. In about 5% of patients with symptomatic reflux, the symptoms are primarily so severe that immediate pediatric surgical treatment is necessary (Fig.1).