BACKGROUND: Children with neurological disorders present a higher incidence of reflux, and generally symptoms do not get better with clinical treatment, making surgical interventions a necessary action. AIM: To compare the results of the anti-reflux surgery in normal children and in those with neurological disorders, identifying the leading complications and causes of re-operation. METHODS: One hundred and twenty children with gastroesophageal reflux were distributed into two groups of study: Group I - 60 normal children; Group II - 60 children with neurological disorders. Barited contrast of aesophagus, stomach and duodenum, high endoscopy with biopsy, 24 hours esophageal pHmetry and cintilography were the tests utilized in the diagnosis and evaluation of the efficacy of the surgery. All operated patients were refractory to clinical treatment prior to surgery. The anti-reflux surgery performed was Lind fundoplication, being associated to gastrostomy in 55% of the Group II patients. RESULTS: In Group II, surgery was indicated earlier than Group I. Among neuropaths, their highly affected neural psyquic motor development and repeated pneumonia were the main causes of surgery indication. Hospitalization time, number of re-operations and the need for post-operation esophageal dilatation were greater in Group II (p<0.01). Three deaths occurred in Group II during late post-operative period (sepsis and severe respiratory infection). CONCLUSION: The procedure performed is satisfactory for surgical reflux treatment. However, further studies of neuropath children population with reflux are imperative as they respond less favorably to surgery with regard to mortality rates, recurrence of respiratory symptoms, re-operation rates and severity of post-operative complications.
Gastroesophageal reflux; Esophagitis, peptic; Neurologic manifestations
