TREATMENT OF GASTROESOPHAGEAL REFLUX AND HIATAL-HERNIA BY BOEREMA ANTERIOR GASTROPEXY

The authors present their experience with Boerema anterior gastropexy in the surgical treatment of gastroesophageal reflux (GER) in 105 children operated upon for GER without (71) and with (34) a hiatal hernia. The operative technique was gastropexy according to Boerema, plus retroesophageal hiatopexy for cases of major hiatal hernia. At follow-up, 95 children (almost 90%) were completely asymptomatic and 7 showed mild symptoms with minimally abnormal radiographic findings. Clinical and radiographic recurrences occurred in 3 patients, 2 with severe brain damage. Two children were reoperated for postoperative ileus due to adhesions. The mortality was zero. In the author's opinion, the Boerema procedure is a very simple, safe, and effective technique that is associated with very few complications and negligible mortality and should be considered the method of choice in the surgical treatment of GER and hiatal hernia in non-mentally-retarded children.