Twenty severely mentally retarded children with significant gastrooesophageal reflux were submitted to surgical treatment. In all patients vomiting was present to a distressing degree. Seven had experienced haematemesis, and a lower oesophageal stricture was present in 5 children, 3 of whom required extensive surgery to overcome the obstruction. All had failed to respond to conservative measures. Although the postoperative complication rate was high (50%), the final result in the majority of patients was highly satisfactory.
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