NISSEN FUNDOPLICATION FOR GASTROESOPHAGEAL REFLUX DISEASE - LONG-TERMRESULTS

Since its introduction by Rudolph Nissen in 1956, fundoplication has b ecome the most commonly used antireflux procedure. Following fundoplic ation the majority (80 to 90 %) of the patients become symptomfree or have only mild and occasional reflux symptoms in the long run. With a short and loose fundic wrap postoperative dysphagia is not a clinical problem, providing that preoperative manometry shows adequate peristal sis. Flatus is increased after fundoplication, but rarely to a disturb ing extent. Patients who have problems with flatus preoperatively are also prone to have complaints postoperatively. Bloating is decreased r ather than increased after fundoplication. At endoscopy as intact seen fundic wrap (the main determinant of the long-term outcome) is observ ed in 70 % to 80 % of the eases 10 to 20 years after the operation. Oe sophageal 24-hour pH-recording is normal and oesophagitis cured in sim ilar number of patients. In conclusion, Nissen fundoplication gives ef fective cure of symptoms of gastro-oesophageal reflux disease and reli ably corrects reflux oesophagitis. Postoperative adverse effects are r are and well tolerable and do not detract from the success of the oper ation in correctly selected patients.