title: Operative treatment of gastroesophageal reflux in low birth weight infants.
abstract: Operative correction of symptomatic gastroesophageal reflux (GER) has been used frequently and successfully in both children and larger infants for many years. In contrast, surgical repair of GER has been applied relatively sparingly in very small infants because of perceived technical and postoperative difficulties. We retrospectively reviewed our experience with Nissen fundoplications performed for symptomatic GER in low birth weight (LBW) infants ( < or = 2500 grams the time of surgery). Twenty-one consecutive cases from 1988 to 1993 were evaluated. At the time of surgery, the average age was 9.1 weeks and the average weight was 2100 grams (range, 1220 to 2500 grams). All infants had failed a trial of medical management. Follow-up from 1 month to 5 years showed no intraoperative complications and resolution of symptoms in 91 per cent of our patients. Technical factors found to enhance the success of the operative repairs included appropriately sized dilators, division of the short gastric vessels, and a loose 360-degree wrap. With suitable technique, the surgical management of symptomatic GER can be performed safely in small infants.
authors.affiliation: Kaiser Permanente Medical Center, Los Angeles, California, USA.
authors.forename: V L
authors.initials: VL
authors.lastname: Rowe
authors.forename: M
authors.initials: M
authors.lastname: Krishnamoorthy
authors.forename: H
authors.initials: H
authors.lastname: Applebaum
mesh_terms: D005260:Female; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies