Surgery of gastroesophageal reflux

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Abstract
During the last 20 years, 262 patients were diagnosed with gastroesophageal reflux (GER) at La Timone Children's Hospital, Marseille, France. Seventy‐eight patients (60 infants and 18 children) were treated operatively. Both newer investigations such as scintiscan and Ph measurements, as well as standard ones, such as barium esophagogram and esophagoscopy, failed to demonstrate a precise relationship between reflux and symptoms. Selection of patients for surgery depends on clinical symptoms linked to GER, for example, failure of a 3‐week medical trial, association with anatomic disorders such as hiatal hernia, and respiratory complications proven to originate from GER. Numerous surgical procedures have been described. The best appears to be the Nissen fundoplication associated with gastropexy.