[size=20px]The risk of developing recurrent gastroesophageal reflux disease following fundoplication is highest in children

 

A less than six years old.

 

B with neurologic impairment.

 

C with a preoperative hiatal hernia.

 

D with postoperative retching.

 

E with postoperative dysphagia requiring esophageal dilatation.[/size]

E

E with postoperative dysphagia requiring esophageal dilatation

correct answer

E with postoperative dysphagia requiring esophageal dilatation.

 

Ngerncham performed a retrospective case controlled study matched for surgeon, operative approach (laparoscopic versus open), technique (partial versus complete) and approximate operative era. Age less than six years, preoperative hiatal hernia, postoperative retching and postoperative esophageal dilation were all significant risk factors for recurrent gastroesophageal reflux disease (GERD). However, the highest odds ratio was associated with postoperative dysphagia requiring esophageal dilatation. Despite earlier reports emphasizing the risk of neurologic impairment this factor was not associated with increased risk for recurrent disease when controlled for the other factors. In a meta-analysis of several large series of adult fundoplications for GERD, identifying reliable preoperative predictors of surgical outcomes remains problematic.