Esophagogastric Dissociation versus Fundoplication in Managing Gastroesophageal Reflux in Neurologically Impaired Children

While gastroesophageal reflux (GER) is usually a benign condition in healthy children, in neurologically impaired children, particularly those with swallowing difficulties, it can lead to significant problems such as malnutrition and recurrent respiratory infections. Surgical fundoplication accompanied by a feeding gastrostomy has become the favored treatment of GER among such children despite a significant risk of post-operative morbidity, mortality, and recurrence of symptoms.¹ Accordingly, Bianchi² proposed esophagogastric dissociation (EGD) as an alternative intervention for such children for whom gastrostomy feeding was …