Fundoplication Physiology and Its Impact on Aerodigestive Disorders

Fundoplication is one of the most common operations performed in children. It is highly successful to control gastroesophageal reflux, but it has major physiologic effects on upper gastrointestinal function leading to complications. The performance of a fundoplication in aerodigestive patients is complicated by the fact that there are no simple tools to diagnose gastroesophageal reflux in these patients, that many aerodigestive symptoms are attributed erroneously to gastroesophageal reflux, and that aerodigestive patients already have upper GI dysfunction, making the prevalence of complications higher. Therefore, patient selection for surgery is of paramount importance.