Collis-Nissen gastroplasty fundoplication for complicated gastro-oesophageal reflux disease.
Collis-Nissen gastroplasty fundoplication is a widely accepted operation for patients with gastro-oesophageal reflux disease complicated by oesophageal shortening. Assessment of this operation by 24 h oesophageal pH monitoring has not previously been reported. Our aim was to correlate clinical and endoscopic results with 24 h pH studies. Twenty-nine patients had a gastroplasty fundoplication, as a result of which twenty-five (86%) had an excellent clinical result, 2 (7%) had a good result and 2 (7%) had a poor result. The two poor results were in patients who had previously undergone anti-reflux surgery. All 29 patients had pre-operative pH monitoring. Twenty-three patients had postoperative pH studies. Oesophageal acidification times were normal postoperatively in 16 of 23 patients however, 7 still had an abnormal study. One of the two patients with a poor clinical result was studied and persistent severe oesophageal acidification was demonstrated. The remaining 6 patients with abnormal studies were asymptomatic. Five of the 6 asymptomatic patients also had a normal oesophagogastroscopy with no macroscopic oesophagitis. We conclude that 24 h pH monitoring after the Collis-Nissen operation should only be performed to assess clinically and endoscopically poor results.
Martin
C J
CJ
St Vincent's Hospital, Fitzroy, Victoria, Australia.
Cox
M R
MR
Cade
R J
RJ
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004947:Esophagus / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D005748:Gastric Fundus / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008722:Methods; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012086:Reoperation; D013270:Stomach / Q000601:surgery