The current role of laparoscopic surgery for gastroesophageal reflux disease in infants and children

Background: The benefits of surgery for gastroesophageal reflux disease (GERD) in infants and children have been questioned in the recent literature. The goal of this review was to determine the best current practice for the diagnosis and management of this disease. Methods: The literature was reviewed for all recent English language publications on the management of GERD in 8- to 10-year-old patients. Results: In infants and children, GERD has multiple etiologies, and an understanding of these is important for determining which patients are the best surgical candidates. Proton pump inhibitors (PPIs) have become the mainstay of current treatment for primary GERD. Although laparoscopic surgery appears to be better than open surgery, there remains some morbidity and complications that careful patient selection can minimize. Conclusion: Surgery for GERD should be performed only after failure of medical management or for specific problems that mandate it.