Total Fundoplication with or without Gastroplasty for Gastroesophageal Reflux: Comparative Study
| Autor: | Manuel Tomás-Ridocci, Francisco Mora, F. París, Adolfo Benages, Ricardo Guijarro, C. Carbonell-Canti, Carlos Carbonell-Antolí, Ramon Molina, Eduardo Moreno-Osset, José Padilla |
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| Rok vydání: | 1985 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Manometry medicine.medical_treatment Nissen fundoplication Asymptomatic Gastroenterology Hiatal hernia Postoperative Complications Recurrence Internal medicine Total fundoplication medicine Animals Humans Hernia Reflux esophagitis Surgical repair business.industry Reflux Hydrogen-Ion Concentration Middle Aged medicine.disease digestive system diseases Surgery Radiography Hernia Hiatal surgical procedures operative Evaluation Studies as Topic Gastroesophageal Reflux Female Esophagogastric Junction medicine.symptom Deglutition Disorders Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 39:508-511 |
| ISSN: | 0003-4975 |
| Popis: | The results of clinical, radiographic, manometric, and pH-metric studies of two groups of patients with reflux esophagitis treated by total (Nissen) fundoplication with or without a Collis esophagus-lengthening gastroplasty were compared. On postoperative follow-up, clinical recurrence of gastrophageal reflux was found in 5 of the 76 patients in the Nissen group, whereas none of the 46 patients in the Collis-Nissen group had reflux. A dramatic reduction in the clinical score was observed for all patients, and postoperative clinical morbidity was similar in both groups. Postoperative radiographic recurrence of hiatal hernia was found in 11 of 60 patients in the Nissen group, but not in any of the patients in the Collis-Nissen group. The lower esophageal sphincter pressure was significantly increased after operation in both groups (p less than 0.05). The postoperative "common cavity test" and acid reflux test were positive in 9% of the patients having Nissen fundoplication alone and 11% of those having the Collis-Nissen procedure; in the latter group, both tests were positive in only 1 asymptomatic patient. These results demonstrate that the standard Nissen repair is a good surgical technique for management of uncomplicated reflux esophagitis and that the Collis-Nissen procedure is the most effective method of surgical repair for almost all patients with complicated reflux esophagitis. |
| Databáze: | OpenAIRE |
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