目的　以食管动力学和胃食管反流评估食管裂孔旁疝和混合疝的 3种抗反流手术疗效。方法　 2 4例 1 5月龄～ 3岁 ,体重 (7 39± 2 0 2 )kg的病儿中 ,15例用食管裂孔修补加Dor手术 ,5例加Toupet手术 ,3例仅做单纯修补 ;1例自愈。同时进行了手术前后食管动力及 2 4h食管pH监测。结果　术前除 3例不存在胃食管反流外 ,余均存在不同程度胃食管反流。术后优良率为 91 3% ;食管狭窄 5例 ,仅 1例有吞咽困难症状。术后食管下括约肌压力 [(2 4 72± 9 6 6 )mmHg对 (2 0 45± 9 0 1)mmHg(1mmHg =0 133kPa) ]以Toupet术增高明显 ;食管下括约肌长度 [(2 31± 0 6 5 )cm对 (1 36± 0 5 3)cm]以Dor手术增长明显。术后 2 4h食管pH监测参数明显改善 ,并以Toupet手术改善最显著。结论　 3种抗反流手术均能有效减轻胃食管反流 ,以Toupet手术效果最佳 Objective To evaluate the efficacy of three kinds of anti-reflux surgery for esophageal hippocampal hernia and mixed hernia with esophageal motility and gastroesophageal reflux. Methods Twenty-five cases of 14-year-old to 3-year-old children with body weight of (7 39 ± 20 2) kg were treated with esophagectomy plus Dor operation, 5 with Toupet operation and 3 with simple repair. 1 case of self-healing. Esophageal motility and 24 h esophageal pH monitoring were performed before and after surgery. Results In 3 cases before operation, there was no gastroesophageal reflux. All the patients had some degree of gastroesophageal reflux. Postoperative excellent rate of 91 3%; esophageal stricture in 5 cases, only 1 case of dysphagia symptoms. The postoperative esophageal sphincter pressure (2 4 72 ± 96 6) mmHg versus (20 45 ± 90 1) mmHg (1 mmHg = 0 133 kPa)] was significantly increased with Toupet’s surgery. The length of the lower esophageal sphincter [(2 31 ± 0 6 5) cm vs (1 36 ± 0 5 3) cm] increased significantly with Dor procedure. The esophageal pH monitoring parameters were significantly improved at 24 hours after surgery and were most significantly improved by Toupet surgery. Conclusion All the three kinds of anti-reflux surgery can effectively reduce gastroesophageal reflux, and the best results are achieved by Toupet operation