[Indication for operation and results in cardia insufficiency with or without hiatic hernia in childhood (author's transl)].

Abstract

After discussing the problems in cardia insufficiency in childhood it is suggested that conservative treatment is indicated in minor-oesophageal refluxes, most medium-range refluxes and hiatic hernias of minor degree. Surgical treatment is indicated if conservative therapy over 4 weeks is ineffective. Still and absolute indication for operation must be distinguished from a relative indication. Absolute indications are: oesophagitis, oesophageal stricture, Roviralta's-syndrome, major refluxes, some medium-range refluxes as well as all hiatic hernias except minor forms in young infants. Relative indications are: refluxes accompanied by cyanotic attacks possibly leading to sudden infant death, recurrent pneumonias or rumination. Mortality was 2,3% in all 211 patients and zero during the last 10 years. In 98% of 160 patients who were reexamined, satisfactory results were achieved. Recurrencies occurred only following thoracic operations formerly in use, whereas today operations for cardia insufficiency are exclusively abdominal.