The efficacy of Thal fundoplication in the treatment of gastroesophageal reflux: the influence of central nervous system impairment.
One hundred sixteen patients underwent a modified Thal fundoplication to correct gastroesophageal reflux (GER) between July 1, 1983, and January 30, 1987. Ninety-one percent of patients were relieved of GER. When patients were evaluated with respect to the presence or absence of CNS impairment there was a marked difference in the success rate of this procedure. Eight of 48 patients with CNS disorders had recurrent reflux with gastrostomy feedings after a modified Thal fundoplication (16%) while only two of 68 neurologically normal children had a failure of operation (3%; P less than .05). These data indicate that the modified Thal fundoplication is very effective in correcting GER in neurologically normal children but is less effective in children with CNS impairment.
Tuggle
D W
DW
Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City.
Tunell
W P
WP
Hoelzer
D J
DJ
Smith
E I
EI
D000293:Adolescent; D002493:Central Nervous System Diseases / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D005748:Gastric Fundus / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008722:Methods; D011183:Postoperative Complications; D012086:Reoperation