WOFAPS 2025 8th World Congress of Pediatric Surgery

Servet Melike Akıncı, Özlem Boybeyi, Tutku Soyer

Hacettepe University Faculty of Medicine Department of Pediatric Surgery

Aim: To compare the outcomes of children with and without anti-reflux surgery during congenital hiatal hernia (CHH) repair.

Methods: Children operated on CHH were evaluated for demographic and clinical features, surgical treatment and outcomes. The outcomes of CHH repair were compared in children with and without anti-reflux surgery.

Results: Between xxxx-xx, 20 children operated on CCH, with a median age of 16 months (interquartile range: 8.25-62.5) were included. The male to female ratio was 13:7. Type-1 and 3 (n=8, 40% each) were the most common type of CHH, whereas type-2 and 4 were reported in two of the cases. 60% (n=12) of cases had symptoms of gastroesophageal reflux (GER) and noted in preoperative imaging. Patients with preoperative GER has significantly higher rate of failure to thrive (p=0.04), persistent cough (p=0.01) and dysphagia (p=0,003). 70% (n=13) of patient underwent anti-reflux surgery during CHH repair. Anti-reflux surgery was performed in 7 of type-1 (88%), 5 (63%) of type-3 cases and one in type-2 (50%) case. When postoperative outcomes compared, there was no difference between patients with and without anti-reflux surgery for postoperative persistent cough, recurrent infections, early-late dumping syndrome, need for proton pump inhibitors, wound infections, bowel obstruction, surgical complications and recurrence (p>0.05). Recurrence was noted in 6 (30%) of the cases in which 4 of them had anti-reflux surgery and 2 were did not have. Recurrence was most commonly seen after CCH repair for type-1 (n=4, 67%). Although there was no difference in age of diagnosis in patients with and without recurrence (p>0.05). recurrence was more common in males (p=0,036). There was no difference between patient with and without recurrence for clinical features and postoperative outcomes (p>0.05).

Conclusion: Anti-reflux surgery during CHH repair had similar postoperative outcomes in patients without anti-reflux surgery. Recurrence is not a rare complication after surgery and mostly seen in male patients with type-1 CHH.