EN
TÜRKÇE
Poster - 158
Results of surgical treatment of gastroesophageal reflux in children
Abdumanap Alkhasov, Maria Shubina, Nikolay Shubin, Sergey Ratnikov, Alena Comina, Anna Shmykova
National Medical Research Center for Children’s Health, Moscow, Russia
Relevance: gastroesophageal reflux in children among all diseases of the esophagus takes the first place. In parts, possible works occupy more than 10%.
Methods: From 2019 to 2025, 385 children were operated on for gastroesophageal reflux and its complications.
Results: All children underwent Nissen fundoplication. Laparoscopic access was used predominantly. In 5% of cases, surgical intervention was performed for giant hernias of the esophageal opening of the diaphragm with excision of the hernial sac. In 30% of cases, suturing of the diaphragm crura was performed due to sliding hernias. About 13% of patients operated on for gastroesophageal reflux had concomitant pathologies - esophageal atresia. Also, the presence of sliding hernia was noted in such patients. About 40% of patients have severe neurological pathology.Peptic stenosis of the esophagus, as one of the possible complications of GERD, was detected in 3% of cases (10 patients). Esophageal bougienage was performed, which was effective in 3 patients. 7 patients required extirpation of the esophagus. The average duration of the surgical intervention was 20-160 minutes. In the postoperative period, the children were activated and enteral loading began on the first postoperative day. The average duration of the patient's stay in the hospital after surgical treatment was 5-12 days.
In the long-term observation periods from 6 to 24 months, good results were obtained in most children. In 2% of cases (8 patients), relapse of gastroesophageal reflux was detected, which in half of the cases was observed in children with severe CNS damage. And in 0.5% of cases (2 patients), dysphagia phenomena were observed due to hyperfunction of the cuff.
Conclusion: Our experience in treating children with gastroesophageal reflux shows that the use of laparoscopic Nissen fundoplication has a long-term clinical outcome. It also improves the quality of life of children with concomitant surgical and neurological pathologies.