LONG-TERM QUANTITATIVE RESULTS FOLLOWING FUNDOPLICATION AND ANTROPLASTY FOR GASTROESOPHAGEAL REFLUX AND DELAYED GASTRIC-EMPTYING IN CHILDREN

BACKGROUND: The operative management of children with combined gastroe sophageal reflux and delayed gastric emptying is controversial. This s tudy measures the long-term follow-up of gastric emptying in children who have undergone gastroesophageal fundoplication combined with antro plasty. METHODS: Fifteen randomly selected children with gastroesophag eal reflux and scintigraphically demonstrated delayed gastric emptying underwent fundoplication and antroplasty. Each patient had another ga stric emptying scintigraphic study performed an average of 3.6 years p ostoperation. RESULTS: All patients reported improvement of their symp toms compared with before the operation, and none required further med ical therapy for gastroesophageal reflux or experienced dumping syndro me. Eleven of the 15 patients had significant long-term improvement of their gastric emptying postoperatively. The mean percent of isotope m eal remaining in the stomach at 90 minutes improved from 72% preoperat ively to 40% postoperatively (P = 0.0005). CONCLUSIONS: Gastric emptyi ng in children with gastroesophageal reflux and delayed gastric emptyi ng is significantly improved for several years in three-fourths of pat ients after fundoplication and antroplasty. Fundoplication and concomi tant antroplasty are recommended for symptomatic children with documen ted gastroesophageal reflux and delayed gastric emptying. (C) 1998 by Excerpta Medica, Inc.