One year follow-up results in the surgical treatment of gastroesophageal reflux disease.
BACKGROUND
Gastroesophageal reflux disease (GERD) is a common intestinal disorder. Although fundoplication immediately achieves good results, some problems arise about duration.


METHODS
From 1990 to 1992, thirty-seven patients underwent operation for GERD, the indications for surgery being: persistence of reflux symptoms after at least 6 months of medical therapy, esophagitis, manometric evidence of LES incompetence, augmented esophageal exposure to gastric juice documented by 24 hours pH monitoring. Nissen-Rossetti was the technique used; intraoperative calibration was 29.8 mmHg.


RESULTS
Twenty-five patients were studied 12 months after the operation. They were submitted to clinical examination, gastroscopy, manometry, 24 hours pH monitoring. Clinically 2 patients were unable to belch. All of them showed LESP and intra-abdominal HPZ length decreased (32.3% and 13.5% respectively). The factors influencing LESP 12 months after surgery are age and intraoperative calibration. Pressure decrease is related to age and calibration. An older patient will show a smaller decrement, to a higher intraoperative pressure corresponds a higher pressure decrease with time.


CONCLUSIONS
For these reasons we do not recommend hypercalibration especially in the elderly.
Nano
M
M
Department of Genatric Sciences, School of Medicine, University of Turin Italy.
Redivo
L
L
Fonte
G
G
Dal Corso
H M
HM
Gasparri
G
G
Lanfranco
G
G
D000367:Age Factors; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome