Uncut Collis-Nissen gastroplasty: early functional results.
BACKGROUND
This study reviewed the short-term results of the uncut Collis-Nissen gastroplasty.


METHODS
From 1990 through 1993, 27 consecutive patients (16 men, 11 women) underwent an uncut Collis-Nissen gastroplasty. Mean age was 59 years (range, 30 to 75 years). Three patients had a previous failed antireflux procedure. Indications for operation were gastroesophageal reflux disease resistant to medical treatment in 18 patients and symptomatic hiatal hernia in 9 patients. Fourteen patients had Barrett's esophagus and 4 had a peptic stricture. Complete esophageal function testing including barium swallow, endoscopy, manometry, and 24-hour pH recording was performed in 26 of 27 patients preoperatively and postoperatively.


RESULTS
Five patients (19%) had complications, which included atelectasis in 2, cardiac dysrhythmia in 2, and prolonged ileus in 1. There were no operative deaths. Follow-up was complete in all patients and ranged from 8 to 45 months (mean, 22 months). Subjectively, symptoms of reflux were resolved in all patients. Six patients complain of slow esophageal emptying and 3 have occasional episodes of dysphagia. None required postoperative dilation. Ulcers and erosions healed in all 26 patients who underwent endoscopy but recurred in 2 at 21 and 36 months postoperatively. Mean lower esophageal sphincter gradient increased from 8.3 mm Hg preoperatively to 14.6 mm Hg (p = 0.0001). Total percent of acid exposure decreased from 8.0% preoperatively to 1.7% (p = 0.003).


CONCLUSIONS
We conclude that the uncut Collis-Nissen procedure provides acceptable short-term control of gastroesophageal reflux disease.
Pera
M
M
Department of Surgery, Université de Montréal, Hôtel-Dieu de Montréal, Québec, Canada.
Deschamps
C
C
Taillefer
R
R
Duranceau
A
A
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000601:surgery; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D015391:Gastroplasty / Q000379:methods; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome