Gastrectomy in Infancy and Childhood

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Abstract
An international survey of experiences of pediatric surgeons with gastric resection in the first 12 years of life is presented to supplement meager published experience with this operation in infants and children. Data on 113 gastric resections have been collected and analyzed. Ninety-eight resections were subtotal distal or total and 15 were esophagogastric. Forty-four per cent of the distal subtotal and total resections were carried out in the first 2 years of life. The operative mortality for distal subtotal and total resection was 10%. All deaths occurred in patients operated upon in the first 6 years and all fatal operations were performed for bleeding, perforation or both. Indications for resection are reviewed by ages. Peptic ulcer was the most frequently encountered indication (42 cases), followed by gastric scarring or perforation resulting from ingestion of toxic material (13 cases), duplication of the stomach (11 cases) and benign and malignant gastric neoplasms (7 cases each). All but one of 15 esophagogastric resections were carried out for esophageal varices or esophagitis complicating hiatal hernia. There were 2 operative deaths in this group. The most significant finding of this study was the consistently normal growth and development following distal subtotal gastric resection, or even total gastrectomy. Resection involving the cardioesophageal junction, on the other hand, was associated with a high degree of retardation of growth and development.